Organization Active NPI

Theresa M Reed PHD PC

  • Clinical Psychologist
  • Missoula, MT
National Provider Identifier
1477887420
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
THERESA M REED PHD PC
Practice address
119 W Front St
Suite 309
Missoula, MT 59802-4011
Phone
(406) 327-6663
Fax
(406) 327-9987
NPI assigned
Sep 23, 2009
Last updated
Sep 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Authorized official

Name
Theresa M Reed, PHDNPI 1356370761
Title
Owner/Provider
Phone
(406) 327-6663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

119 W Front St
Suite 309
Missoula, MT 59802-4011

Mailing address

119 W Front St
Suite 309
Missoula, MT 59802-4011
Phone (406) 327-6663

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091023000243 MT Part B Supplier - Clinic/Group Practice 2860539848 Receives reassigned benefits from 1 practitioner
Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

119 W Front St
Ste 309
Missoula, MT 59802
Phone (406) 327-6663

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253664000000",
    "number": "1477887420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W FRONT ST",
            "address_2": "SUITE 309",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024011",
            "telephone_number": "406-327-6663",
            "fax_number": "406-327-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W FRONT ST",
            "address_2": "SUITE 309",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024011",
            "telephone_number": "406-327-6663",
            "fax_number": "406-327-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERESA M REED PHD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "THERESA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "406-327-6663",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.