Breathe Mind Body Therapy LLC
Organization Active NPI Mental Health Counselor · Bozeman, MT
NPI 1235529322 · NPPES record last updated Nov 8, 2024
Key facts
- NPI
- 1235529322
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Mental Health Counselor 101YM0800X
- Legal business name
- BREATHE MIND BODY THERAPY LLC
- Practice address
- 2417 W Main St Ste 2
Bozeman, MT 59718-3811 - Phone
- (406) 600-4297
- NPI assigned
- Jan 28, 2015
- Organization subpart
- No
Authorized official
- Name
- Joni Nadene Evans, LCPC & LMFT
- Title
- Owner/Sole Proprietor
- Phone
- (406) 600-4297
Practitioners 5
-
Danielle Schacter, MS, LCPC
-
Joni Nadene Evans, LCPC
-
Tara Barrett, PCLC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20241107003846 | MT | Part B Supplier - Clinic/Group Practice | 8123339058 |
Receives reassigned benefits from 2 practitioners Practice locations: Bozeman, MT |
National Provider Directory
Locations
2417 W Main St
Ste 2
Bozeman, MT 59718
Phone (406) 600-4297
205 Haggerty Ln
Ste 255
Bozeman, MT 59715
Phone (406) 600-4013
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor |
101YM0800X | Yes |
Addresses
Primary practice location
2417 W Main St Ste 2
Bozeman, MT 59718-3811
Mailing address
4213 Benepe St
Bozeman, MT 59718-6712
Phone (406) 600-4297
Other providers in Bozeman, MT
- Brandy Houser PLLC
- Hilary Brannen
- Laura M Braun
- Alan D Brayton
- Lisa T Brayton
- Jacob M Breeding
- Natalie Bailey Brehaut
- Tanja Ann Brekke
- Ellie Anne Brennan
- Madison Brenner
All providers in Bozeman, MT · Mental Health Counselor in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.