Sadie Rae Ellingson, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

BBH-LCPC-LIC-25445 Issued in MT

Practice address

445 Centennial Aveunue
Butte, MT 59701-2870

Phone

(406) 723-4075

Fax

(406) 723-3059

NPI assigned

Sep 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sadie Rae Maricich Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Western Montana Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Missoula, MT
  • NPI 1912079328

  Professional

  NPD (past)

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

{
    "created_epoch": "1505174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648425600000",
    "number": "1316466329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "445 CENTENNIAL AVE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597012870",
            "telephone_number": "406-723-4075",
            "fax_number": "406-496-6035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "445 CENTENNIAL AVEUNUE",
            "city": "BUTTE",
            "state": "MT",
            "postal_code": "597012870",
            "telephone_number": "406-723-4075",
            "fax_number": "406-723-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLINGSON",
        "first_name": "SADIE",
        "middle_name": "RAE",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-12",
        "last_updated": "2022-03-28",
        "certification_date": "2022-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "BBH-LCPC-LIC-25445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SADIE",
            "last_name": "MARICICH",
            "middle_name": "RAE",
            "credential": "LCPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allison Katherine Eisenzimer, PHARMD
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• Marylucy Elema, DMD
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• Jan Ellis, LCSW
• William Bruce Ellis, M.D.
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• Dawn M English, LCSW AND LCPC
• Samantha Mikayla Enloe, OTD, OTR/L

• Professional Counselor in Butte, MT
• Providers in Butte, MT by specialty
• Professional Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2022; 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.