Active NPI
Heather Shultz
- Professional Counselor
- Missoula, MT
National Provider Identifier
1104514447
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- BBH-PCLC-LIC-49329
- Practice address
- 700 South Ave W Ste D
Missoula, MT 59801-8011 - Phone
- (406) 219-7673
- NPI assigned
- Apr 25, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | BBH-PCLC-LIC-49329 | MT | Primary |
Addresses
Primary practice location
700 South Ave W Ste D
Missoula, MT 59801-8011
Mailing address
2044 1/2 S 12TH St W
Missoula, MT 59801-5054
Phone (406) 550-3638
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 |
|---|---|---|---|
| BBH-PCLC-LIC-49329 | MT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682380800000",
"number": "1104514447",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2044 1/2 S 12TH ST W",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598015054",
"telephone_number": "406-550-3638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700 SOUTH AVE W STE D",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598018011",
"telephone_number": "406-219-7673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHULTZ",
"first_name": "HEATHER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-04-25",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MT",
"license": "BBH-PCLC-LIC-49329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Apr 25, 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.