Organization Active NPI

Breathe Mind Body Therapy LLC

  • Mental Health Counselor
  • Bozeman, MT
National Provider Identifier
1235529322
Registry record updated Nov 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 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
Last updated
Nov 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2024

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

Authorized official

Name
Joni Nadene Evans, LCPC & LMFTNPI 1063718245
Title
Owner/Sole Proprietor
Phone
(406) 600-4297

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241107003846 MT Part B Supplier - Clinic/Group Practice 8123339058 Receives reassigned benefits from 2 practitioners
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

1946 Stadium Dr
Ste 2
Bozeman, MT 59715
Phone (309) 299-1579

205 Haggerty Ln
Ste 255
Bozeman, MT 59715
Phone (406) 312-9703

2417 W Main St
Ste 2
Bozeman, MT 59718
Phone (406) 600-4297

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1422403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731024000000",
    "number": "1235529322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4213 BENEPE ST",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186712",
            "telephone_number": "406-600-4297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2417 W MAIN ST STE 2",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597183811",
            "telephone_number": "406-600-4297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREATHE MIND BODY THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-28",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "JONI",
        "authorized_official_middle_name": "NADENE",
        "authorized_official_title_or_position": "OWNER/SOLE PROPRIETOR",
        "authorized_official_telephone_number": "406-600-4297",
        "authorized_official_credential": "LCPC & LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.