Danette M Wollersheim, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

249 Issued in MT

Practice address

129 W Kent Ave
Ste I
Missoula, MT 59801-6730

Phone

(406) 542-7365

Fax

(406) 542-1032

NPI assigned

Nov 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Bridget Hanna, LCSW, PLLC

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1760845960
  NPD (past)

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489536000000",
    "number": "1609942069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 W KENT AVE",
            "address_2": "STE I",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016730",
            "telephone_number": "406-542-7365",
            "fax_number": "406-542-1032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 W KENT AVE",
            "address_2": "STE I",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016730",
            "telephone_number": "406-542-7365",
            "fax_number": "406-542-1032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLLERSHEIM",
        "first_name": "DANETTE",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-28",
        "last_updated": "2017-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MT",
            "license": "249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "493168",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "050841",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Without Limits, Inc.
• Zackery W Witte, M.D.
• Carissa Marie Woelich, OD
• Christian Wold, LMSW
• Rochelle Suzanne Wolfe, M.D.
• Mark S Woltanski, MD
• Douglas Keith Womack, L.AC.
• Womens Counseling Center P.C.
• Womens Health LLC
• Gregory A Wood, M.D.

• Clinical Psychologist in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Psychologist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.