Active NPI
Mary Alexine, LCPC, LAC
- Professional Counselor
- Kalispell, MT
National Provider Identifier
1184837577
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 662
- Practice address
- 723 5TH Ave E Ste 138
Kalispell, MT 59901-5326 - Phone
- (406) 290-9344
- NPI assigned
- May 8, 2007
- Last updated
- Oct 19, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 866 | MT | |
| Professional Counselor | 101YP2500X | 662 | MT | Primary |
Addresses
Primary practice location
723 5TH Ave E Ste 138
Kalispell, MT 59901-5326
Mailing address
316 Shady River LN
Whitefish, MT 59937-8200
Phone (406) 290-9344
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
| License | State | Type | Specialty |
|---|---|---|---|
| 866 | MT | MD | Occupational Therapist |
| 662 | MT | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178582400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539907200000",
"number": "1184837577",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "316 SHADY RIVER LN",
"city": "WHITEFISH",
"state": "MT",
"postal_code": "599378200",
"telephone_number": "406-290-9344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "723 5TH AVE E STE 138",
"city": "KALISPELL",
"state": "MT",
"postal_code": "599015326",
"telephone_number": "406-290-9344"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALEXINE",
"first_name": "MARY",
"credential": "LCPC, LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-08",
"last_updated": "2018-10-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "866",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MT",
"license": "662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kalispell, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.