Kim Bodily, PCLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

BBH-PCLC-LIC-43646 Issued in MT

Practice address

600 Central Ave Ste 311
Great Falls, MT 59401-3157

Phone

(406) 209-8747

NPI assigned

Jul 9, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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.

• Connected Brain & Body Based Counseling LLC

  • Professional Counselor
  • Great Falls, MT
  • NPI 1437774809
  NPD (past) Authorized official

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594252800000",
    "number": "1427676014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "928 AVENUE D NW",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594041738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CENTRAL AVE STE 311",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013157",
            "telephone_number": "406-209-8747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODILY",
        "first_name": "KIM",
        "credential": "PCLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-PCLC-LIC-43646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather N Boberg
• Jessica Bobick
• Lorenzo Boccuzzi, D.O.
• Chuck E Bock, MA-CCC. SLP
• Kelsey A. Bock, PA-C
• Ryan Boer, D.O.
• Boes Eye Care
• David A Boes, MD
• Makenna Bogen
• Jeanie Bohall, LCPC

• Mental Health Counselor in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Mental Health Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.