Individual provider Active NPI

Amy Lichtenstein Keefer, L.C.S.W.

  • Clinical Social Worker
  • Bozeman, MT
National Provider Identifier
1972650505
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-509 Issued in MT
Practice address
2050 Fairway Dr
Bozeman, MT 59715-5871
Phone
(406) 581-9855
Fax
(406) 587-9422
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 LCSW-509 MT Primary

Addresses

Primary practice location

2050 Fairway Dr
Bozeman, MT 59715-5871

Mailing address

1202 S Pinecrest Dr
Bozeman, MT 59715-5943
Phone (406) 581-9855

Other identifiers 1

IdentifierTypeStateIssuer
0503625MedicaidMT

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
I20100324000105 MT Practitioner - Clinical Social Worker 0345375770 Reassigns benefits to 1 organization
Practice locations: Bozeman, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1202 S Pinecrest Dr
Bozeman, MT 59715-5943
Phone (406) 581-9855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-509MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Keefer, LLC Clinical CurrentSince Jan 3, 2018 Accepting new patients

Locations

1600 Ellis St
Ste 1C
Bozeman, MT 59715
Phone (406) 223-0886

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1972650505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 S PINECREST DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155943",
            "telephone_number": "406-581-9855",
            "fax_number": "406-587-9422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 FAIRWAY DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155871",
            "telephone_number": "406-581-9855",
            "fax_number": "406-587-9422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "AMY",
        "middle_name": "LICHTENSTEIN",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "LCSW-509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0503625",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.