Medicine Lodge Counseling PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4654 Issued in MT

Legal business name

MEDICINE LODGE COUNSELING PLLC

Practice address

2809 Great Northern Loop Ste 210-5
Missoula, MT 59808-1749

Phone

(406) 360-8470

NPI assigned

Apr 24, 2018

Last updated

Jun 16, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Pamela C Wilson, LCPC LACNPI 1144656455

Title

Clinical Mental Health Counselor

Phone

(406) 360-8470

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

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.

• Pamela C. Wilson, LCPC

  • Professional Counselor
  • Missoula, MT
  • NPI 1144656455
  Medicare reassignment NPD Authorized official
• Brigit Rose Johnson

  • Mental Health Counselor
  • Coupeville, WA
  • NPI 1679975171
  NPD (past)

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

{
    "created_epoch": "1524528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1619465788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14098 JENNY ANN CT UNIT A",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085386",
            "telephone_number": "406-360-8470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2809 GREAT NORTHERN LOOP STE 210-5",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081749",
            "telephone_number": "406-360-8470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICINE LODGE COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-24",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CLINICAL MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "406-360-8470",
        "authorized_official_credential": "LCPC LAC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "4654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medicab
• Elisa Meier
• Nicole Green Meier, DO
• Heidi Maria Meierbachtol, PA-C
• Rachel Meiggs
• Olivia Mekush, LMT

• Professional Counselor in Missoula, MT
• Providers in Missoula, MT by specialty
• Professional Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.