Individual provider Active NPI

Evelyn Ann O Leary Bennett, RN LCPC

  • Rehabilitation Registered Nurse
  • Missoula, MT
National Provider Identifier
1043398571
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Registered NurseTaxonomy code 163WR0400X
License
09268 Issued in MT
Practice address
127 N Higgins Ave RM 206
Missoula, MT 59802-4457
Phone
(406) 549-2625
NPI assigned
Nov 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 484LCPC MT
Rehabilitation Registered Nurse 163WR0400X 09268 MT Primary

Addresses

Primary practice location

127 N Higgins Ave RM 206
Missoula, MT 59802-4457

Mailing address

127 N Higgins Ave RM 206
Missoula, MT 59802-4457
Phone (406) 549-2625

Other identifiers 3

IdentifierTypeStateIssuer
0253657MedicaidMT
13005657OtherMTMT ST FUND PAYEE
74903OtherMTBCBS

Other names 1

  • Evy O Leary Professional name

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
484LCPCMTMDProfessional Counselor
09268MTMDRehabilitation Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1043398571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 N HIGGINS AVE RM 206",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024457",
            "telephone_number": "406-549-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 N HIGGINS AVE RM 206",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024457",
            "telephone_number": "406-549-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O LEARY BENNETT",
        "first_name": "EVELYN",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "RN LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "484LCPC",
            "primary": false
        },
        {
            "code": "163WR0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Rehabilitation",
            "state": "MT",
            "license": "09268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0253657",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT ST FUND PAYEE",
            "identifier": "13005657",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "74903",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EVY",
            "last_name": "O LEARY",
            "credential": "RN LCPC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Sep 11, 2025; 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.