Individual provider Active NPI

Melissa A Ipsen, MSW LCSW

  • Clinical Social Worker
  • Cheyenne, WY
National Provider Identifier
1972747723
Registry record updated Jan 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
297 Issued in WY
Practice address
1504 Stinson Ave
Cheyenne, WY 82001-3319
Phone
(307) 632-8064
Fax
(307) 632-6131
NPI assigned
Apr 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2015

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 297 WY Primary

Addresses

Primary practice location

1504 Stinson Ave
Cheyenne, WY 82001-3319

Mailing address

1504 Stinson Ave
Cheyenne, WY 82001-3319
Phone (307) 632-8064

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

LicenseStateTypeSpecialty
297WYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1240444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422316800000",
    "number": "1972747723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 STINSON AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013319",
            "telephone_number": "307-632-8064",
            "fax_number": "307-632-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1504 STINSON AVE",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013319",
            "telephone_number": "307-632-8064",
            "fax_number": "307-632-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IPSEN",
        "first_name": "MELISSA",
        "middle_name": "A",
        "credential": "MSW  LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-23",
        "last_updated": "2015-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.