Organization Active NPI

David C Segerstrom PC

Doing business as Montana Behavioral Health NW

  • Clinical Social Worker
  • Kalispell, MT
National Provider Identifier
1225043102
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
220 Issued in MT
Legal business name
DAVID C SEGERSTROM PC
Doing business as
Montana Behavioral Health NW
Practice address
38 Village Loop Rd
Kalispell, MT 59901-2793
Phone
(406) 755-7566
Fax
(406) 755-7599
NPI assigned
Jul 29, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Mr. David Charles Segerstrom, LCSW
Title
President
Phone
(406) 755-7566

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 220 MT Primary

Addresses

Primary practice location

38 Village Loop Rd
Kalispell, MT 59901-2793

Mailing address

38 Village Loop Rd
Kalispell, MT 59901-2793
Phone (406) 755-7566

Other names 1

  • Montana Behavioral Health NW Doing business as

National Provider Directory

National Provider Directory

Locations

28 Village Loop Rd
Kalispell, MT 59901
Phone (406) 571-3909

38 Village Loop Rd
Kalispell, MT 59901
Phone (406) 755-7566

NPI Registry JSON

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

{
    "created_epoch": "1154131200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1225043102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 VILLAGE LOOP RD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012793",
            "telephone_number": "406-755-7566",
            "fax_number": "406-755-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38 VILLAGE LOOP RD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012793",
            "telephone_number": "406-755-7566",
            "fax_number": "406-755-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID C SEGERSTROM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-29",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "SEGERSTROM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-755-7566",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montana Behavioral Health NW",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jul 21, 2022; 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.