Individual provider Active NPI

Dirk Erick Schenck, LCPC

  • Professional Counselor
  • Bozeman, MT
National Provider Identifier
1295764751
Registry record updated Apr 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
MT2330 Issued in MT
Practice address
1600 Ellis St
Suite 1C
Bozeman, MT 59715-8837
Phone
(240) 731-0945
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LC1476 MD
Professional Counselor 101YP2500X PC2232 PA
Professional Counselor 101YP2500X MT2330 MT Primary

Addresses

Primary practice location

1600 Ellis St
Suite 1C
Bozeman, MT 59715-8837

Mailing address

923 W Clark St
Livingston, MT 59047-2917
Phone (240) 731-0945

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
LC1476MDMDProfessional Counselor
MT2330MTMDProfessional Counselor
PC2232PAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1295764751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 W CLARK ST",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590472917",
            "telephone_number": "240-731-0945",
            "fax_number": "215-220-3989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ELLIS ST",
            "address_2": "SUITE 1C",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597158837",
            "telephone_number": "240-731-0945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHENCK",
        "first_name": "DIRK",
        "middle_name": "ERICK",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC1476",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC2232",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "MT2330",
            "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 Apr 28, 2014; 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.