Individual provider Active NPI

Kaycie Brianne Soper, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1750087003
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-64320 Issued in MT
Practice address
401 Railroad St W
Missoula, MT 59802-4178
Phone
(406) 258-4789
Fax
(406) 258-4732
NPI assigned
Feb 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 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-64320 MT Primary

Addresses

Primary practice location

401 Railroad St W
Missoula, MT 59802-4178

Mailing address

401 Railroad St W
Missoula, MT 59802-4178
Phone (406) 258-4789

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
I20231013002646 MT Practitioner - Clinical Social Worker 7618322496 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Partnership Health Center IncGroup PAC ID 6103843479, 51 clinicians

Practice addresses (Care Compare)

1110 W Broadway St
Missoula, MT 59802-3918
Phone (406) 728-1809

1150 Sherwood St
Missoula, MT 59802-2377
Phone 40625847894430

323 W Alder St
Missoula, MT 59802-4123
Phone (406) 258-4789

401 Railroad St W
Missoula, MT 59802-4178
Phone (406) 258-4789

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-LCSW-LIC-64320MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Partnership Health Center Inc CurrentSince Aug 2, 2023 Accepting new patients
Partnership Health Center Inc Current Accepting new patients
Mountain Home Montana Inc Clinical PastSince Feb 1, 2023 Accepting new patients

Locations

401 Railroad St W
Missoula, MT 59802
Phone (406) 258-4183

323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195

Organizations & group practices 3

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": "1675728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1750087003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024178",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024178",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOPER",
        "first_name": "KAYCIE",
        "middle_name": "BRIANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-64320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.