Active NPI
Vibrant Life Therapy LLC
- Professional Counselor
- Bozeman, MT
National Provider Identifier
1366100711
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 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 DirectoryLocations
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.