Individual provider Active NPI

Jaci Marie Hanley, LAC,SWLC

  • Addiction (Substance Use Disorder) Counselor
  • Butte, MT
National Provider Identifier
1154996536
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
BBH-LAC-LIC-57045 Issued in MT
Practice address
445 Centennial Ave
Butte, MT 59701-2870
Phone
(406) 723-4075
Fax
(406) 723-3059
NPI assigned
May 26, 2021
Last updated
Jul 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X BBH-LAC-LIC-57045 MT Primary
Social Worker 104100000X
Clinical Social Worker 1041C0700X BBH-LCSW-LIC-72075 MT

Addresses

Primary practice location

445 Centennial Ave
Butte, MT 59701-2870

Mailing address

445 Centennial Ave
Butte, MT 59701-2870
Phone (406) 496-6000

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

LicenseStateTypeSpecialty
BBH-LAC-LIC-57045MTMDAddiction (Substance Use Disorder) Counselor
BBH-LCSW-LIC-72075MTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Seeds Wellness Clinical Current Accepting new patients
Boyd Andrew Community Services PastSince Jun 1, 2021 Accepting new patients

Locations

125 W Granite St
Butte, MT 59701
Phone (406) 498-6929

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1154996536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CENTENNIAL AVE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597012870",
            "telephone_number": "406-496-6000",
            "fax_number": "406-496-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CENTENNIAL AVE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597012870",
            "telephone_number": "406-723-4075",
            "fax_number": "406-723-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANLEY",
        "first_name": "JACI",
        "middle_name": "MARIE",
        "credential": "LAC,SWLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "BBH-LAC-LIC-57045",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-72075",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Butte, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; 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.