Active NPI
Alexa Ralicki, PSYD
- Clinical Psychologist
- Bozeman, MT
National Provider Identifier
1043857733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY-LIC-2976
- Practice address
- 1351 Stoneridge Dr Ste D
Bozeman, MT 59718-7079 - Phone
- (406) 519-4099
- NPI assigned
- Dec 2, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY-LIC-2976 | MT | Primary |
Addresses
Primary practice location
1351 Stoneridge Dr Ste D
Bozeman, MT 59718-7079
Mailing address
2201 Baxter LN # 10415
Bozeman, MT 59718
Phone (406) 519-4099
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
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-LIC-2976 | MT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1575244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675209600000",
"number": "1043857733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2201 BAXTER LN # 10415",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "59718",
"telephone_number": "406-519-4099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1351 STONERIDGE DR STE D",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597187079",
"telephone_number": "406-519-4099"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RALICKI",
"first_name": "ALEXA",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-12-02",
"last_updated": "2023-02-01",
"certification_date": "2023-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MT",
"license": "PSY-LIC-2976",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.