Stacy Jennings

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4670 Issued in MT

Practice address

110 E Broadway St Ste 204
Missoula, MT 59802-4592

Phone

(406) 370-4664

NPI assigned

Jan 15, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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.

• Missoula Family Therapy, LLC

  • Professional Counselor
  • Missoula, MT
  • NPI 1750712808
  NPD (past) Authorized official

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

{
    "created_epoch": "1389744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389744000000",
    "number": "1437571007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E BROADWAY ST STE 204",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024592",
            "telephone_number": "406-370-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E BROADWAY ST STE 204",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024592",
            "telephone_number": "406-370-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNINGS",
        "first_name": "STACY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-15",
        "last_updated": "2014-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "4670",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MT",
            "license": "4925",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynne M Jenko, PT
• Catherine B. Jenni, PH.D.
• Mary Catherine Jenni, LCSW
• Jennifer Walrod, LCSW, PLLC
• Donna K Jennings, A.P.R.N.
• Sophia Jensen, LCPC
• Jerde Orthodontics PLLC
• Kaia Jerde, DDS
• Greta Jernberg, LAC, LCSW
• Jessica Cardiff,PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.