Individual provider Active NPI

Gwen Renee Sensenig, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1770714057
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWP-LCSW-LIC-4599 Issued in MT
Practice address
210 N Higgins Ave Ste 311
Missoula, MT 59802-4497
Phone
(406) 239-7560
NPI assigned
Aug 4, 2009
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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 1142 AK
Clinical Social Worker 1041C0700X SWP-LCSW-LIC-4599 MT Primary

Addresses

Primary practice location

210 N Higgins Ave Ste 311
Missoula, MT 59802-4497

Mailing address

PO Box 8506
Missoula, MT 59807-8506
Phone (406) 239-7560

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
I20200428000262 MT Practitioner - Clinical Social Worker 9537599840 Practice locations: Missoula, MT

Care Compare profile

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

Practice addresses (Care Compare)

210 N Higgins Ave
Suite 311
Missoula, MT 59802-4497
Phone (406) 239-7560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1142AKMDClinical Social Worker
SWP-LCSW-LIC-4599MTMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1770714057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8506",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598078506",
            "telephone_number": "406-239-7560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HIGGINS AVE STE 311",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024497",
            "telephone_number": "406-239-7560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SENSENIG",
        "first_name": "GWEN",
        "middle_name": "RENEE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-04",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "1142",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "SWP-LCSW-LIC-4599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.