Individual provider Active NPI

Ezekiel Michael Vandehei, PCLC

  • Mental Health Counselor
  • Kalispell, MT
National Provider Identifier
1265129811
Registry record updated Apr 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
BBH-PCLC-LIC-62687 Issued in MT
Practice address
307 1St Ave E Ste 22
Kalispell, MT 59901-4965
Phone
(406) 607-9156
NPI assigned
Apr 21, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X BBH-PCLC-LIC-62687 MT Primary

Addresses

Primary practice location

307 1St Ave E Ste 22
Kalispell, MT 59901-4965

Mailing address

307 1St Ave E Ste 22
Kalispell, MT 59901-4965
Phone (406) 607-9156

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BBH-PCLC-LIC-62687MTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682035200000",
    "number": "1265129811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 1ST AVE E STE 22",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014965",
            "telephone_number": "406-607-9156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 1ST AVE E STE 22",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599014965",
            "telephone_number": "406-607-9156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDEHEI",
        "first_name": "EZEKIEL",
        "middle_name": "MICHAEL",
        "credential": "PCLC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-04-21",
        "certification_date": "2023-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-PCLC-LIC-62687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 21, 2023; 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.