Active NPI
Nancy Elizabeth Errebo, PSYD
- Psychologist
- Missoula, MT
National Provider Identifier
1508088865
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 265
- Practice address
- 300 West Broadway
Suite 2a
Missoula, MT 59802 - Phone
- (406) 251-2659
- Fax
- (406) 329-3006
- NPI assigned
- May 3, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 265 | MT | Primary |
| Psychologist | 103T00000X | 1825 | AZ |
Addresses
Primary practice location
300 West Broadway
Suite 2a
Missoula, MT 59802
Mailing address
300 West Broadway
Suite 2a
Missoula, MT 59802
Phone (406) 251-2659
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51081 | Other | MT | BLUE CROSS BLUE SHIELD |
| 0493376 | 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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 265 | MT | MD | Professional Counselor |
| 1825 | AZ | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Facilitating Life Changes Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Psychologist
- Missoula, MT
- NPI 1942287891
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508088865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 WEST BROADWAY",
"address_2": "SUITE 2A",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59802",
"telephone_number": "406-251-2659",
"fax_number": "406-329-3006"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 WEST BROADWAY",
"address_2": "SUITE 2A",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59802",
"telephone_number": "406-251-2659",
"fax_number": "406-329-3006"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ERREBO",
"first_name": "NANCY",
"middle_name": "ELIZABETH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MT",
"license": "265",
"primary": true
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "AZ",
"license": "1825",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51081",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0493376",
"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.