Individual provider Active NPI

Dylan Rincker, LCSW

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1912329764
Registry record updated Jan 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SWP-LCSW-LIC-4927 Issued in MT
Practice address
3255 LT Moss Rd
Missoula, MT 59804-7220
Phone
(406) 532-9800
NPI assigned
Jan 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2014

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 SWP-LCSW-LIC-4927 MT Primary

Addresses

Primary practice location

3255 LT Moss Rd
Missoula, MT 59804-7220

Mailing address

17255 Remount Rd
Huson, MT 59846-9718
Phone (406) 544-8950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SWP-LCSW-LIC-4927MTMDClinical 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, 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": "1389657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389657600000",
    "number": "1912329764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17255 REMOUNT RD",
            "city": "HUSON",
            "state": "MT",
            "postal_code": "598469718",
            "telephone_number": "406-544-8950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3255 LT MOSS RD",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047220",
            "telephone_number": "406-532-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RINCKER",
        "first_name": "DYLAN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-01-14",
        "last_updated": "2014-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "SWP-LCSW-LIC-4927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.