Alembic Psychotherapy Incorporated

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

162LCSW Issued in MT

Legal business name

ALEMBIC PSYCHOTHERAPY INCORPORATED

Practice address

725 W Alder St
Ste. 28
Missoula, MT 59802-4026

Phone

(406) 728-4791

Fax

(406) 728-4791

NPI assigned

Mar 30, 2012

Last updated

Jun 15, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Victor Stampley, LCSWNPI 1508877291

Title

President

Phone

(406) 728-4791

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Victor Labarre Stampley, LCSW

  • Clinical Social Worker
  • Superior, MT
  • NPI 1508877291
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1333065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339718400000",
    "number": "1114293354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3505 W FORK PETTY CREEK RD",
            "city": "ALBERTON",
            "state": "MT",
            "postal_code": "598209313",
            "telephone_number": "406-728-4791",
            "fax_number": "406-728-4791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 W ALDER ST",
            "address_2": "STE. 28",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024026",
            "telephone_number": "406-728-4791",
            "fax_number": "406-728-4791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALEMBIC PSYCHOTHERAPY INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-06-15",
        "status": "A",
        "authorized_official_last_name": "STAMPLEY",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-728-4791",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "162LCSW",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.