Individual provider Active NPI

Debra A Lang, PSY.D.

  • Psychologist
  • Bozeman, MT
National Provider Identifier
1174739023
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
351 Issued in MT
Practice address
65B W Kagy Blvd
Bozeman, MT 59715-6052
Phone
(406) 585-7167
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 351 MT Primary
Psychologist 103T00000X 2635 CO

Addresses

Primary practice location

65B W Kagy Blvd
Bozeman, MT 59715-6052

Mailing address

65B W Kagy Blvd
Bozeman, MT 59715-6052
Phone (406) 585-7167

Other identifiers 2

IdentifierTypeStateIssuer
0492133MedicaidMT
52261OtherMTBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

13818 Crystal CRK
Bigfork, MT 59911-7352
Phone (406) 570-9215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2635COMDPhysician Assistant
351MTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Creating Choices PC Psychologist CurrentSince Feb 15, 2010 Accepting new patients

Locations

65B W Kagy Blvd
Bozeman, MT 59715
Phone (406) 585-7167

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174739023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "65B W KAGY BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156052",
            "telephone_number": "406-585-7167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65B W KAGY BLVD",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156052",
            "telephone_number": "406-585-7167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "DEBRA",
        "middle_name": "A",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MT",
            "license": "351",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CO",
            "license": "2635",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0492133",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "52261",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

Verify at the official NPI Registry.