Individual provider Active NPI

David Bennett Stube, PHD

  • Professional Counselor
  • Missoula, MT
National Provider Identifier
1073699740
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
364 Issued in MT
Practice address
537 Stephens Ave
Missoula, MT 59801-3813
Phone
(406) 542-8222
Fax
(406) 542-1590
NPI assigned
Oct 27, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 364 MT Primary

Addresses

Primary practice location

537 Stephens Ave
Missoula, MT 59801-3813

Mailing address

537 Stephens Ave
Missoula, MT 59801-3813
Phone (406) 542-8222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20251125003534 MT Practitioner - Mental Health Counselor 8527550672 Practice locations: Missoula, MT

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

537 Stephens Ave
Missoula, MT 59801-3813
Phone (406) 481-0974

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
364MTMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073699740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "537 STEPHENS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013813",
            "telephone_number": "406-542-8222",
            "fax_number": "406-542-1590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "537 STEPHENS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598013813",
            "telephone_number": "406-542-8222",
            "fax_number": "406-542-1590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUBE",
        "first_name": "DAVID",
        "middle_name": "BENNETT",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.