NPIMap

Organization Active NPI

Jeffrey K. Ellens, PH.D. PLC

  • Counseling Psychologist
  • Bozeman, MT
National Provider Identifier
1093102741
Registry record updated May 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
Legal business name
JEFFREY K. ELLENS, PH.D. PLC
Practice address
106 E Babcock St Ste 1B
Bozeman, MT 59715-4820
Phone
(406) 577-2410
Fax
(406) 573-1070
NPI assigned
Apr 21, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2023

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

Authorized official

Name
Ms. Jennifer Boling
Title
Office Manager/Owner
Phone
(619) 807-7143

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 001132 IA
Counseling PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC1900X Primary

Addresses

Primary practice location

106 E Babcock St Ste 1B
Bozeman, MT 59715-4820

Mailing address

1045 76TH St
Suite 3030
West Des Moines, IA 50266-5834
Phone (515) 777-3388

Other names 1

  • Lotus Counseling of Montana Doing business as

National Provider Directory

National Provider Directory

Locations

1045 76th St
Unit 3030
West Des Moines, IA 50266
Phone (515) 777-3388

106 E Babcock St
Ste 1B
Bozeman, MT 59715
Phone (406) 577-2410

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1429574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684195200000",
    "number": "1093102741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 76TH ST",
            "address_2": "SUITE 3030",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502665834",
            "telephone_number": "515-777-3388",
            "fax_number": "515-777-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 E BABCOCK ST STE 1B",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597154820",
            "telephone_number": "406-577-2410",
            "fax_number": "406-573-1070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY K. ELLENS, PH.D. PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-21",
        "last_updated": "2023-05-16",
        "certification_date": "2023-05-16",
        "status": "A",
        "authorized_official_last_name": "BOLING",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OFFICE MANAGER/OWNER",
        "authorized_official_telephone_number": "619-807-7143",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IA",
            "license": "001132",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lotus Counseling of Montana",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 May 16, 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.

Verify at the official NPI Registry.