Individual provider Active NPI

Brandon Kwasnik, LCSW

  • Clinical Social Worker
  • Bozeman, MT
National Provider Identifier
1760013981
Registry record updated Jan 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-42587 Issued in MT
Practice address
141 Discovery Dr Ste 103
Bozeman, MT 59718-4134
Phone
(406) 210-7916
NPI assigned
Jan 27, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2020

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-42587 MT Primary

Addresses

Primary practice location

141 Discovery Dr Ste 103
Bozeman, MT 59718-4134

Mailing address

141 Discovery Dr Ste 103
Bozeman, MT 59718-4134
Phone (406) 210-7916

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
I20240816000531 MT Practitioner - Clinical Social Worker 0143768531 Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BBH-LCSW-LIC-42587MTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1580083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580083200000",
    "number": "1760013981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 DISCOVERY DR STE 103",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597184134",
            "telephone_number": "406-210-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 DISCOVERY DR STE 103",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597184134",
            "telephone_number": "406-210-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWASNIK",
        "first_name": "BRANDON",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-27",
        "last_updated": "2020-01-27",
        "certification_date": "2020-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-42587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.