Individual provider Active NPI

Dana Eisenberg, L.C.S.W.

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1881643476
Registry record updated Oct 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
580 LCSW Issued in MT
Practice address
528 Cleveland St
Missoula, MT 59801-3743
Phone
(406) 549-6800
NPI assigned
May 9, 2006
Last updated
Oct 13, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 59867 MT
Clinical Social Worker 1041C0700X 580 LCSW MT Primary

Addresses

Primary practice location

528 Cleveland St
Missoula, MT 59801-3743

Mailing address

528 Cleveland St
Missoula, MT 59801-3743
Phone (406) 549-6800

Other identifiers 2

IdentifierTypeStateIssuer
502758MedicaidMT
70095OtherMTBCBS

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
I20060523000124 MT Practitioner - Clinical Social Worker 2567473945 Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

528 Cleveland St
Missoula, MT 59801-3743
Phone (406) 239-1106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
59867MTMDSchool Counselor
580 LCSWMTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Dana Eisenberg, LCSW Counseling and Consultation, LLC PastSince Apr 28, 2017 Accepting new patients

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": "1147132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444694400000",
    "number": "1881643476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 CLEVELAND ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013743",
            "telephone_number": "406-549-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "528 CLEVELAND ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013743",
            "telephone_number": "406-549-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISENBERG",
        "first_name": "DANA",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-09",
        "last_updated": "2015-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "MT",
            "license": "59867",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "580 LCSW",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "502758",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "70095",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.