Individual provider Active NPI

Theresa Oakland, M.S. LAC

  • Addiction (Substance Use Disorder) Counselor
  • Polson, MT
National Provider Identifier
1295766152
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
1023 Issued in MT
Practice address
802 Main St Ste C
Polson, MT 59860-3200
Phone
(406) 883-7310
Fax
(406) 883-7312
NPI assigned
Jul 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1023 MT Primary

Addresses

Primary practice location

802 Main St Ste C
Polson, MT 59860-3200

Mailing address

802 Main St Ste C
Polson, MT 59860-3200
Phone (406) 883-7310

Other identifiers 2

IdentifierTypeStateIssuer
760710OtherMTBLUE CROSS BLUE SHIELD
0320099MedicaidMT

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1023MTMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Chemical Dependency Program Past Accepting new patients
Western Montana Mental Health Center Addiction (Substance Use Disorder) Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1295766152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 MAIN ST STE C",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598603200",
            "telephone_number": "406-883-7310",
            "fax_number": "406-883-7312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MAIN ST STE C",
            "city": "POLSON",
            "state": "MT",
            "postal_code": "598603200",
            "telephone_number": "406-883-7310",
            "fax_number": "406-883-7312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OAKLAND",
        "first_name": "THERESA",
        "credential": "M.S. LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "1023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "760710",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0320099",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Polson, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.