Individual provider Active NPI

Adria Eva Dean Willis, LCSW

  • Clinical Social Worker
  • Helena, MT
National Provider Identifier
1689194391
Registry record updated Jun 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-14681 Issued in MT
Practice address
2550 E Broadway St
Helena, MT 59601-4905
Phone
(406) 495-6998
Fax
(406) 495-6995
NPI assigned
Jun 23, 2017
Last updated
Jun 23, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 23, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X BBH-LCSW-LIC-14681 MT Primary

Addresses

Primary practice location

2550 E Broadway St
Helena, MT 59601-4905

Mailing address

710 Red Letter St
Helena, MT 59601-5808
Phone (307) 851-3832

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200628000009 MT Practitioner - Clinical Social Worker 9638591290 Practice locations: Helena, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

48 Medical Park Dr
Helena, MT 59601-4925
Phone (307) 851-3832

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Adria Willis, LCSW L.L.C. Clinical CurrentSince May 28, 2020 Accepting new patients

Locations

48 Medical Park Dr
Helena, MT 59601
Phone (406) 449-3880

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498176000000",
    "number": "1689194391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 RED LETTER ST",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596015808",
            "telephone_number": "307-851-3832",
            "fax_number": "406-495-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 E BROADWAY ST",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596014905",
            "telephone_number": "406-495-6998",
            "fax_number": "406-495-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "ADRIA",
        "middle_name": "EVA DEAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-23",
        "last_updated": "2017-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-14681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Helena, MT

Sources for this page

Verify at the official NPI Registry.