Pamela C. Wilson, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4654 Issued in MT

Practice address

2809 Great Northern Loop Ste 210-5
Missoula, MT 59808-1749

Phone

(406) 360-8470

NPI assigned

Sep 18, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Pamela C. Tollefson Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Medicine Lodge Counseling PLLC

  • Professional Counselor
  • Missoula, MT
  • NPI 1619465788
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1379462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522108800000",
    "number": "1144656455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14098 JENNY ANN CT UNIT A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085386",
            "telephone_number": "406-360-8470",
            "fax_number": "406-360-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 GREAT NORTHERN LOOP STE 210-5",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081749",
            "telephone_number": "406-360-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PAMELA",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-18",
        "last_updated": "2018-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "4654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "TOLLEFSON",
            "middle_name": "C.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David Lee Wilson, M.D.
• Eva Freese Wilson, ND
• Lauren Sarah Wilson, M.D.
• Lennard Steven Wilson, M.D.
• Mark Wilson, DC
• Philip Michael Wilson, D.D.S.
• Tara Mahoney Wilson, MSPT, OCS, CSCS
• Tiana Wilson, LCSW
• Tracy Louise Wilson, LCPCC
• David E Wiltfong, LCSW

• Professional Counselor in Missoula, MT
• Providers in Missoula, MT by specialty
• Professional Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.