Individual provider Active NPI

Matthew T. Radlowski, LCSW, LAC

  • Addiction (Substance Use Disorder) Counselor
  • Missoula, MT
National Provider Identifier
1720303357
Registry record updated Jul 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1344 Issued in MT
Practice address
1325 Wyoming St
Missoula, MT 59801-1725
Phone
(406) 532-9800
Fax
(406) 541-3032
NPI assigned
Apr 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2280 MT
Addiction (Substance Use Disorder) Counselor 101YA0400X 1344 MT Primary

Addresses

Primary practice location

1325 Wyoming St
Missoula, MT 59801-1725

Mailing address

Building T9 Fort Missoula
Missoula, MT 59804-7298
Phone (406) 532-8400

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
I20140717001648 MT Practitioner - Clinical Social Worker 0941426514 Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

334 E Broadway
Missoula, MT 59802-4618
Phone (406) 426-1586

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2280MTMDClinical Social Worker
1344MTMDMedical Technologist

NPI Registry JSON

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

{
    "created_epoch": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405814400000",
    "number": "1720303357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BUILDING T9 FORT MISSOULA",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047298",
            "telephone_number": "406-532-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 WYOMING ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011725",
            "telephone_number": "406-532-9800",
            "fax_number": "406-541-3032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADLOWSKI",
        "first_name": "MATTHEW",
        "middle_name": "T.",
        "credential": "LCSW, LAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-07",
        "last_updated": "2014-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "2280",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "1344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.