Individual provider Active NPI

Elizabeth Nicole Bassler, LCSW

  • Clinical Social Worker
  • Polson, MT
National Provider Identifier
1932601796
Registry record updated Jan 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
29843 Issued in MT
Practice address
6 13TH Ave E
Polson, MT 59860-5315
Phone
(406) 883-5680
Fax
(406) 883-8910
NPI assigned
Mar 7, 2018
Last updated
Jan 22, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X NU
Clinical Social Worker 1041C0700X 29843 MT Primary

Addresses

Primary practice location

6 13TH Ave E
Polson, MT 59860-5315

Mailing address

44959 Schoolhouse LN
Charlo, MT 59824-9449

Other practice location 1

314 1st St E
Polson, MT 59860-2148
Phone (630) 219-8019

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
I20190417001101 MT Practitioner - Clinical Social Worker 6305187501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Annie FlorinGroup PAC ID 5496152571, 4 clinicians

Practice addresses (Care Compare)

2809 Connery Way
Suite B
Missoula, MT 59808-1955
Phone (406) 219-1267

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Credena Health LLC CurrentSince Feb 25, 2020 Accepting new patients
Providence St Joseph Medical Center CurrentSince Feb 25, 2020 Accepting new patients
Brave Journey PLLC Social Worker CurrentSince Jul 7, 2019 Accepting new patients
Annie Florin Clinical CurrentSince Jun 1, 2024 Accepting new patients
Annie Florin Clinical PastSince Aug 8, 2021 Accepting new patients

Locations

2809 Connery Way
Ste B
Missoula, MT 59808
Phone (208) 502-0664

500 W Broadway St
Ste 320
Missoula, MT 59802
Phone (406) 329-2945

6 13th Ave E
Polson, MT 59860
Phone (406) 883-5377

Organizations & group practices 5

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": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1932601796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44959 SCHOOLHOUSE LN",
            "city": "CHARLO",
            "state": "MT",
            "postal_code": "598249449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 13TH AVE E",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598605315",
            "telephone_number": "406-883-5680",
            "fax_number": "406-883-8910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "314 1st St E",
            "address_purpose": "LOCATION",
            "city": "Polson",
            "state": "MT",
            "postal_code": "598602148",
            "country_code": "US",
            "telephone_number": "630-219-8019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BASSLER",
        "first_name": "ELIZABETH",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "29843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

Verify at the official NPI Registry.