Individual provider Active NPI

Forest Daniel Henning, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1871763391
Registry record updated Jan 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
825 Issued in MT
Practice address
910 Brooks St Ste 101
Missoula, MT 59801-5784
Phone
(406) 721-4918
Fax
(406) 329-3006
NPI assigned
Mar 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2022

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 825 MT Primary

Addresses

Primary practice location

910 Brooks St Ste 101
Missoula, MT 59801-5784

Mailing address

PO Box 4821
Missoula, MT 59806-4821
Phone (406) 531-0702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
825MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elkhorn Professional Services Clinical CurrentSince Sep 25, 2019 Accepting new patients

Locations

101 E Broadway St
Ste 405
Missoula, MT 59802
Phone (406) 531-0702

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": "1205280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643587200000",
    "number": "1871763391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4821",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598064821",
            "telephone_number": "406-531-0702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BROOKS ST STE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015784",
            "telephone_number": "406-721-4918",
            "fax_number": "406-329-3006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENNING",
        "first_name": "FOREST",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-12",
        "last_updated": "2022-01-31",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "825",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.