Individual provider Active NPI

John Edward Sheehan III, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1831657717
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
37179 Issued in MT
Practice address
520 S 3Rd St W
Missoula, MT 59801
Phone
(406) 209-8826
NPI assigned
Mar 9, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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 37179 MT Primary

Addresses

Primary practice location

520 S 3Rd St W
Missoula, MT 59801

Mailing address

PO Box 5631
Missoula, MT 59806-5631
Phone (406) 396-5179

Other practice location 1

1801 S 11th St W
Missoula, MT 59801-4833
Phone (406) 396-5179

Other practice location 2

1801 S 11th St W
Missoula, MT 59801-4833
Phone (406) 396-5179

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL johnsheehanlcsw@gmail.com

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
I20201106000229 MT Practitioner - Clinical Social Worker 0840600649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

520 S 3Rd St W
Missoula, MT 59801-2518
Phone (406) 209-8826

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37179MTMDClinical Social Worker

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1552089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1831657717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5631",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598065631",
            "telephone_number": "406-396-5179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S 3RD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59801",
            "telephone_number": "406-209-8826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 S 11th St W",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598014833",
            "country_code": "US",
            "telephone_number": "406-396-5179",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1801 S 11th St W",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598014833",
            "country_code": "US",
            "telephone_number": "406-396-5179",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHEEHAN",
        "first_name": "JOHN",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-09",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "37179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "johnsheehanlcsw@gmail.com",
            "affiliation": "N",
            "address_1": "520 S 3rd St W",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "59801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.