Organization Active NPI

Vibrant Life Therapy LLC

  • Professional Counselor
  • Bozeman, MT
National Provider Identifier
1366100711
Registry record updated Aug 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
VIBRANT LIFE THERAPY LLC
Practice address
304 Gallatin Park Dr Unit 207
Bozeman, MT 59715-7945
Phone
(406) 600-3300
Fax
(406) 404-1041
NPI assigned
Dec 2, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2022

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

Authorized official

Name
Ms. Rebekah Leigh Driessen Patrick, LCPC
Title
Owner
Phone
(406) 600-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

304 Gallatin Park Dr Unit 207
Bozeman, MT 59715-7945

Mailing address

1807 W Dickerson St Ste D
Bozeman, MT 59715-1311
Phone (406) 600-3300

National Provider Directory

National Provider Directory

Locations

304 Gallatin Park Dr
Unit 207
Bozeman, MT 59715
Phone (406) 600-3300

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1366100711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 W DICKERSON ST STE D",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597151311",
            "telephone_number": "406-600-3300",
            "fax_number": "406-551-1055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 GALLATIN PARK DR UNIT 207",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597157945",
            "telephone_number": "406-600-3300",
            "fax_number": "406-404-1041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT LIFE THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-02",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "PATRICK",
        "authorized_official_first_name": "REBEKAH",
        "authorized_official_middle_name": "LEIGH DRIESSEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-600-3300",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "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 Aug 10, 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.