Individual provider Active NPI

Jessica McDanold, LCSW

  • Clinical Social Worker
  • Sidney, MT
National Provider Identifier
1780956300
Registry record updated Oct 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1007 Issued in MT
Practice address
1405 4TH St SW
Sidney, MT 59270-3515
Phone
(406) 643-4095
Fax
(406) 433-3586
NPI assigned
Jan 27, 2012
Last updated
Oct 9, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2019

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 1007 MT Primary
Marriage & Family Therapist 106H00000X 108 MT

Addresses

Primary practice location

1405 4TH St SW
Sidney, MT 59270-3515

Mailing address

PO Box 1407
Sidney, MT 59270-1407
Phone (406) 643-4095

Other practice location 1

107 Dilworth St
Glendive, MT 59330-2053
Phone (406) 345-8901

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
I20161116001611 MT Practitioner - Clinical Social Worker 7618136235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

216 E Main St
Sidney, MT 59270-4328
Phone (406) 643-4095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
108MTMDClinical Social Worker
1007MTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunrise Wellness Center, LLC Clinical CurrentSince Aug 1, 2019 Accepting new patients

Locations

216 E Main St
Sidney, MT 59270
Phone (406) 643-4095

216 E Main St
Ste 2
Sidney, MT 59270
Phone (406) 643-4095

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1327622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570579200000",
    "number": "1780956300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1407",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592701407",
            "telephone_number": "406-643-4095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1405 4TH ST SW",
            "city": "SIDNEY",
            "state": "MT",
            "postal_code": "592703515",
            "telephone_number": "406-643-4095",
            "fax_number": "406-433-3586"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 Dilworth St",
            "address_purpose": "LOCATION",
            "city": "Glendive",
            "state": "MT",
            "postal_code": "593302053",
            "country_code": "US",
            "telephone_number": "406-345-8901",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDANOLD",
        "first_name": "JESSICA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-27",
        "last_updated": "2019-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "1007",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MT",
            "license": "108",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sidney, MT

Sources for this page

Verify at the official NPI Registry.