Organization Active NPI

Tia Utzinger PLLC

  • Clinical Social Worker
  • Bozeman, MT
National Provider Identifier
1821475765
Registry record updated Oct 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
555LCSW Issued in MT
Legal business name
TIA UTZINGER PLLC
Practice address
501 E Peach St
Bozeman, MT 59715-3000
Phone
(406) 579-9011
NPI assigned
Apr 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Tia Ebba Utzinger, L.C.S.W.NPI 1346636099
Title
Therapist
Phone
(406) 579-9011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 555LCSW MT Primary

Addresses

Primary practice location

501 E Peach St
Bozeman, MT 59715-3000

Mailing address

PO Box 6087
Bozeman, MT 59771-6087
Phone (406) 579-9011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200916002977 MT Part B Supplier - Clinic/Group Practice 3476971854 Receives reassigned benefits from 1 practitioner
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

501 E Peach St
Bozeman, MT 59715
Phone (406) 579-9011

614 S Ferguson Ave
Ste 3
Bozeman, MT 59718
Phone (406) 579-9011

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603670400000",
    "number": "1821475765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6087",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597716087",
            "telephone_number": "406-579-9011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 E PEACH ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153000",
            "telephone_number": "406-579-9011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIA UTZINGER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A",
        "authorized_official_last_name": "UTZINGER",
        "authorized_official_first_name": "TIA",
        "authorized_official_middle_name": "EBBA",
        "authorized_official_title_or_position": "THERAPIST",
        "authorized_official_telephone_number": "406-579-9011",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "L.C.S.W."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "555LCSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.