Individual provider Active NPI

Leslie Anne Johnson, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1750005989
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-55408 Issued in MT
Practice address
900 N Orange St Ste 202
Missoula, MT 59802-2951
Phone
(406) 327-3362
NPI assigned
Sep 30, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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-55408 MT Primary

Addresses

Primary practice location

900 N Orange St Ste 202
Missoula, MT 59802-2951

Mailing address

PO Box 12
Liberty Lake, WA 99019-0012
Phone (866) 747-2455

Other practice location 1

2777 Renae Ct
Missoula, MT 59804-1104
Phone (406) 529-9419

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
I20230721001947 MT Practitioner - Clinical Social Worker 6103286158 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

900 N Orange St
Missoula, MT 59802-2951
Phone (406) 327-3362

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-LCSW-LIC-55408MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Mt Clinical CurrentSince Aug 1, 2023 Accepting new patients
Providence St Joseph Medical Center CurrentSince Aug 1, 2023 Accepting new patients
Credena Health LLC CurrentSince Aug 1, 2023 Accepting new patients
Providence Health & Services Mt Current Accepting new patients
Providence Health & Services Mt CurrentSince Aug 1, 2023 Accepting new patients

Locations

900 N Orange St
Ste 202
Missoula, MT 59802
Phone (406) 327-1670

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1750005989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "LIBERTY LAKE",
            "state": "WA",
            "postal_code": "990190012",
            "telephone_number": "866-747-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 N ORANGE ST STE 202",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598022951",
            "telephone_number": "406-327-3362"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2777 Renae Ct",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598041104",
            "country_code": "US",
            "telephone_number": "406-529-9419",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LESLIE",
        "middle_name": "ANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-30",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-55408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.