Active NPI
Katherine L Gillispie, LCSW, BCBA
- Clinical Social Worker
- Missoula, MT
National Provider Identifier
1033475736
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 964
- Practice address
- 210 N Higgins Ave Ste 337
Missoula, MT 59802-4443 - Phone
- (406) 529-9516
- Fax
- (888) 978-6176
- NPI assigned
- Apr 6, 2012
- 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 | 964 | MT | Primary |
| Behavior Analyst | 103K00000X | 1-12-10348 | MT |
Addresses
Primary practice location
210 N Higgins Ave Ste 337
Missoula, MT 59802-4443
Mailing address
PO Box 5814
Missoula, MT 59806-5814
Phone (406) 529-9516
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 77039 | Medicaid | MT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | www.missoulatherapist.com | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 1, 2025 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 964 | MT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1333670400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641168000000",
"number": "1033475736",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 5814",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598065814",
"telephone_number": "406-529-9516"
},
{
"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": "406-529-9516",
"fax_number": "888-978-6176"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLISPIE",
"first_name": "KATHERINE",
"middle_name": "L",
"credential": "LCSW, BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-04-06",
"last_updated": "2022-01-03",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MT",
"license": "964",
"primary": true
},
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "MT",
"license": "1-12-10348",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "77039",
"state": "MT"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "www.missoulatherapist.com",
"affiliation": "N",
"endpointDescription": "secure website",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "210 N Higgins Ave Ste 337",
"city": "Missoula",
"state": "MT",
"country_code": "US",
"postal_code": "598024443",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Jan 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.