Individual provider Active NPI

Shan Guisinger, PH.D.

  • Clinical Psychologist
  • Missoula, MT
National Provider Identifier
1184842635
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
164 Issued in MT
Practice address
210 N Higgins Ave
Ste 310
Missoula, MT 59802-4462
Phone
(406) 543-8138
NPI assigned
Apr 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 164 MT Primary

Addresses

Primary practice location

210 N Higgins Ave
Ste 310
Missoula, MT 59802-4462

Mailing address

210 N Higgins Ave
Ste 310
Missoula, MT 59802-4462
Phone (406) 543-8138

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
164MTMDPodiatrist

NPI Registry JSON

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

{
    "created_epoch": "1177200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184842635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N HIGGINS AVE",
            "address_2": "STE 310",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024462",
            "telephone_number": "406-543-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N HIGGINS AVE",
            "address_2": "STE 310",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024462",
            "telephone_number": "406-543-8138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUISINGER",
        "first_name": "SHAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MT",
            "license": "164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.