Joele Mangen
Individual provider Active NPI Behavior Analyst · Billings, MT
NPI 1174153290 · NPPES record last updated Mar 1, 2023
Key facts
- NPI
- 1174153290
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Behavior Analyst 103K00000X
- License
- PSY-BA-LIC-4480 (MT)
- Practice address
- 708 Broadwater Ave
Billings, MT 59101-2710 - Phone
- (406) 259-1680
- Fax
- (406) 259-1777
- NPI assigned
- Jan 16, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY-BA-LIC-4480 | MT | MD | Behavioral Analyst |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Therapy Clinic | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | PSY-BA-LIC-4480 | MT | Yes |
Addresses
Primary practice location
708 Broadwater Ave
Billings, MT 59101-2710
Mailing address
708 Broadwater Ave
Billings, MT 59101-2710
Phone (406) 259-1680
Other providers in Billings, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.