Western Montana Mental Health Center

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

25102 Issued in MT

Legal business name

WESTERN MONTANA MENTAL HEALTH CENTER

Practice address

1315 Wyoming St
Missoula, MT 59801-1725

Phone

(406) 432-9700

Fax

(406) 541-3035

NPI assigned

Mar 25, 2014

Organization subpart

No

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

Authorized official

Name

Ms. Kimberley Michelle Petersen, N.P.

Title

Psychiatric Nurse Practitioner

Phone

(406) 532-9700

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1395705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395705600000",
    "number": "1164849345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 WYOMING STREET",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 WYOMING ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598011725",
            "telephone_number": "406-432-9700",
            "fax_number": "406-541-3035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN MONTANA MENTAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-25",
        "last_updated": "2014-03-25",
        "status": "A",
        "authorized_official_last_name": "PETERSEN",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_middle_name": "MICHELLE",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITIONER",
        "authorized_official_telephone_number": "406-532-9700",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "N.P."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MT",
            "license": "25102",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1508000878",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Western Montana Clinic PC
• Western Montana Clinic PC
• Western Montana Foot and Ankle PLLC
• Western Montana Hearing and Speech
• Western Montana Mental Health Center
• Western Montana Mental Health Center
• Western Montana Mental Health Center
• Western Montana Mental Health Center
• Western Montana Mental Health Center
• Western Montana Orthotics & Prosthetics, P.C.

• Community/Behavioral Health Agency in Missoula, MT
• Providers in Missoula, MT by specialty
• Community/Behavioral Health Agency in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.