Active NPI
Dodie A Moquin, LCPC LICENSE 616
- Mental Health Counselor
- Missoula, MT
National Provider Identifier
1407922008
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 616
- Practice address
- 210 N Higgins
#214
Missoula, MT 59801 - Phone
- (406) 721-6349
- Fax
- (406) 721-6349
- NPI assigned
- Nov 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 616 | MT | Primary |
Addresses
Primary practice location
210 N Higgins
#214
Missoula, MT 59801
Mailing address
10410 Grant Creek Rd
Missoula, MT 59808
Phone (406) 721-8466
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0254774 | Medicaid | MT |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407922008",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10410 GRANT CREEK RD",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59808",
"telephone_number": "406-721-8466",
"fax_number": "406-721-8466"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 N HIGGINS",
"address_2": "#214",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59801",
"telephone_number": "406-721-6349",
"fax_number": "406-721-6349"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOQUIN",
"first_name": "DODIE",
"middle_name": "A",
"name_prefix": "Mrs.",
"credential": "LCPC LICENSE 616",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MT",
"license": "616",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0254774",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.