Individual provider Active NPI

Jennifer Robohm

  • Clinical Psychologist
  • Missoula, MT
National Provider Identifier
1073618252
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
354 Issued in MT
Practice address
336 W Spruce St
Missoula, MT 59802-4108
Phone
(406) 370-7479
NPI assigned
Sep 13, 2006
Last updated
Jul 23, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 354 MT Primary

Addresses

Primary practice location

336 W Spruce St
Missoula, MT 59802-4108

Mailing address

91 Campus Dr
PMB #2511
Missoula, MT 59801-4492

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040511001328 MT Practitioner - Clinical Psychologist 0143219360 Reassigns benefits to 1 organization
Practice locations: Missoula, MT
I20260323000229 MT Practitioner - Clinical Psychologist 0143219360 Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

336 W Spruce St
Missoula, MT 59802-4108
Phone (406) 370-7479

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
354MTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Partnership Health Center Inc Current Accepting new patients
Partnership Health Center Inc CurrentSince Jan 2, 2019 Accepting new patients

Locations

323 W Alder St
Missoula, MT 59802
Phone (406) 258-4195

401 Railroad St W
Missoula, MT 59802
Phone (406) 258-4183

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1073618252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 CAMPUS DR",
            "address_2": "PMB #2511",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598014492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 W SPRUCE ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024108",
            "telephone_number": "406-370-7479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBOHM",
        "first_name": "JENNIFER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MT",
            "license": "354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.