Active NPI
Lance E Eller, LAC, LCPC
- Mental Health Counselor
- Lewistown, MT
National Provider Identifier
1629065487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1274
- Practice address
- 505 W Main St
Lewistown, MT 59457-5703 - Phone
- (406) 535-6614
- Fax
- (406) 535-6614
- NPI assigned
- Oct 5, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 743 | MT | |
| Mental Health Counselor | 101YM0800X | 1274 | MT | Primary |
Addresses
Primary practice location
505 W Main St
Lewistown, MT 59457-5703
Mailing address
505 W Main St
Lewistown, MT 59457-5703
Phone (406) 535-6614
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 760600 | Other | MT | BLUE CROSS/BLUE SHIELD |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 743 | MT | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1629065487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 W MAIN ST",
"city": "LEWISTOWN",
"state": "MT",
"postal_code": "594575703",
"telephone_number": "406-535-6614",
"fax_number": "406-535-6614"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 W MAIN ST",
"city": "LEWISTOWN",
"state": "MT",
"postal_code": "594575703",
"telephone_number": "406-535-6614",
"fax_number": "406-535-6614"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELLER",
"first_name": "LANCE",
"middle_name": "E",
"credential": "LAC, LCPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-05",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "743",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MT",
"license": "1274",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "760600",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lewistown, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.