Candace Mirea, LCSW, LAC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BBH-LCSW-LIC-32896 Issued in MT

Practice address

2809 Connery Way Ste B
Missoula, MT 59808-1955

Phone

(208) 502-0664

NPI assigned

Sep 28, 2016

Last updated

Jun 18, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Specialty

Clinical Social Worker

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empowered Growth Counseling

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1134737620
  Medicare reassignment NPD Authorized official
• Western Montana Mental Health Center

  • Substance Abuse Rehabilitation Facility
  • Missoula, MT
  • NPI 1548659113

  Clinical

  NPD (past)

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

{
    "created_epoch": "1475020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592438400000",
    "number": "1922557123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2809 CONNERY WAY STE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081955",
            "telephone_number": "208-502-0664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 CONNERY WAY STE B",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081955",
            "telephone_number": "208-502-0664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIREA",
        "first_name": "CANDACE",
        "name_prefix": "Mrs.",
        "credential": "LCSW, LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-28",
        "last_updated": "2020-06-18",
        "certification_date": "2020-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "BBH-LAC-LIC-18799",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-32896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.