NPIMap

Organization Active NPI

Dba PHC Russell Elementary

Doing business as PHC Russell Elementary

  • Mental Health Counselor
  • Missoula, MT
National Provider Identifier
1215769906
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
DBA PHC RUSSELL ELEMENTARY
Doing business as
PHC Russell Elementary
Practice address
3216 S Russell St
Missoula, MT 59801-8537
Phone
(406) 370-0487
Fax
(406) 258-4732
NPI assigned
Aug 20, 2024
Last updated
Feb 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Authorized official

Name
Lara Salazar
Title
Billing Manager
Phone
(406) 258-3360

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

3216 S Russell St
Missoula, MT 59801-8537

Mailing address

401 Railroad St W
Missoula, MT 59802-4178
Phone (406) 258-4496

Other practice location 1

401 Railroad St W
Missoula, MT 59802-4178
Phone (406) 258-4789

Other names 1

  • PHC Russell Elementary Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Partnership Health Ctr18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1724112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740096000000",
    "number": "1215769906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 RAILROAD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024178",
            "telephone_number": "406-258-4496",
            "fax_number": "406-258-4578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3216 S RUSSELL ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598018537",
            "telephone_number": "406-370-0487",
            "fax_number": "406-258-4732"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "401 Railroad St W",
            "address_purpose": "LOCATION",
            "city": "Missoula",
            "state": "MT",
            "postal_code": "598024178",
            "country_code": "US",
            "telephone_number": "406-258-4789",
            "fax_number": "406-258-4732",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DBA PHC RUSSELL ELEMENTARY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-20",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A",
        "authorized_official_last_name": "SALAZAR",
        "authorized_official_first_name": "LARA",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "406-258-3360"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PHC Russell Elementary",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PHC Russell Elementary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Feb 21, 2025; 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.