Organization Active NPI

Jennifer Walrod, LCSW, PLLC

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1932441540
Registry record updated Mar 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
JENNIFER WALROD, LCSW, PLLC
Practice address
210 N Higgins Ave Ste 337
Missoula, MT 59802-4443
Phone
(406) 529-7776
Fax
(866) 776-9460
NPI assigned
Mar 21, 2013
Last updated
Mar 21, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2013

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

Authorized official

Name
Jennifer Walrod, LCSWNPI 1003190778
Title
Sole Proprietor
Phone
(406) 529-7776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

210 N Higgins Ave Ste 337
Missoula, MT 59802-4443

Mailing address

210 N Higgins Ave Ste 337
Missoula, MT 59802-4443
Phone (406) 529-7776

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130627000746 MT Part B Supplier - Clinic/Group Practice 3072753888 Receives reassigned benefits from 1 practitioner
Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363824000000",
    "number": "1932441540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N HIGGINS AVE STE 337",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024443",
            "telephone_number": "406-529-7776",
            "fax_number": "866-776-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HIGGINS AVE STE 337",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024443",
            "telephone_number": "406-529-7776",
            "fax_number": "866-776-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNIFER WALROD, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-21",
        "last_updated": "2013-03-21",
        "status": "A",
        "authorized_official_last_name": "WALROD",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "406-529-7776",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "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 Mar 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.