Lisa Rae Birnbaum, ED.S
Individual provider Active NPI School Psychologist · Missoula, MT
NPI 1487316956 · NPPES record last updated Oct 12, 2021
Key facts
- NPI
- 1487316956
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- License
- 72601 (MT)
- Practice address
- 325 E Central Ave
Missoula, MT 59801-6914 - Phone
- (406) 370-1771
- NPI assigned
- Oct 12, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72601 | MT | MD | School Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 72601 | MT | Yes |
Addresses
Primary practice location
325 E Central Ave
Missoula, MT 59801-6914
Mailing address
325 E Central Ave
Missoula, MT 59801-6914
Phone (406) 370-1771
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Missoula |
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All providers in Missoula, MT · School Psychologist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 12, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.