Pati Jo Killebrew-Hall, MT 880 LAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

880 Issued in MT

Practice address

1220 Central Ave Ste 1B
Great Falls, MT 59401

Phone

(406) 268-1587

NPI assigned

Apr 15, 2008

Last updated

Apr 15, 2008By the provider in NPPES

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

Other names 1

• Pati Killebrew-Hall Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Medical Technician

State licenses

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208217600000",
    "number": "1578737250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 CENTRAL AVE STE 1B",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59401",
            "telephone_number": "406-268-1587",
            "fax_number": "406-268-1572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 CENTRAL AVE STE 1B",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "59401",
            "telephone_number": "406-268-1587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLEBREW-HALL",
        "first_name": "PATI",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "MT 880 LAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-15",
        "last_updated": "2008-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MT",
            "license": "880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATI",
            "last_name": "KILLEBREW-HALL",
            "credential": "LAC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Raheel Khalid
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• Nicole Kilian, APRN
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• Larry Wayne Kincer, M.D.
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• Christine M. King, MSC,PSYD,LMFT,LCPC
• Lori Chovanak King, DNP

• Addiction (Substance Use Disorder) Counselor in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Addiction (Substance Use Disorder) Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2008; 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.