Active NPI
Laurelle C Warner, LCSW
- Clinical Social Worker
- Missoula, MT
National Provider Identifier
1922559871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17572
- Practice address
- 2415 Mullan Rd
Missoula, MT 59808-1827 - Phone
- (406) 549-1050
- Fax
- (406) 549-5215
- NPI assigned
- Oct 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17572 | MT | Primary |
| Clinical Social Worker | 1041C0700X | 004048 | CT |
Addresses
Primary practice location
2415 Mullan Rd
Missoula, MT 59808-1827
Mailing address
2415 Mullan Rd
Missoula, MT 59808-1827
Phone (406) 549-1050
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
| License | State | Type | Specialty |
|---|---|---|---|
| 004048 | CT | MD | Clinical Social Worker |
| 17572 | MT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476576000000",
"number": "1922559871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2415 MULLAN RD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598081827",
"telephone_number": "406-549-1050",
"fax_number": "406-549-5215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2415 MULLAN RD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598081827",
"telephone_number": "406-549-1050",
"fax_number": "406-549-5215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARNER",
"first_name": "LAURELLE",
"middle_name": "C",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-16",
"last_updated": "2016-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "17572",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CT",
"license": "004048",
"primary": false
}
],
"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 Oct 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.