Vibrant Life Therapy LLC

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

Last updated

Aug 10, 2022By the provider in NPPES

Organization subpart

No

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

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rebekah Driessen Patrick, MA, LCPC

  • Professional Counselor
  • Bozeman, MT
  • NPI 1518010735
  NPD

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": []
}

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

• 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.