Active NPI
Marilyn J Ivers, LCPC
- Professional Counselor
- Great Falls, MT
National Provider Identifier
1629295969
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 553
- Practice address
- 410 Central Ave
Suite 510
Great Falls, MT 59401 - Phone
- (406) 453-3384
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 553 | MT | Primary |
Addresses
Primary practice location
410 Central Ave
Suite 510
Great Falls, MT 59401
Mailing address
PO Box 234
Great Falls, MT 59403
Phone (406) 453-3384
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 74915 | Other | MT | BLUE CROSS BLUE SHIELD |
| 254150 | 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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 553 | MT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629295969",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 234",
"city": "GREAT FALLS",
"state": "MT",
"postal_code": "59403",
"telephone_number": "406-453-3384"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 CENTRAL AVE",
"address_2": "SUITE 510",
"city": "GREAT FALLS",
"state": "MT",
"postal_code": "59401",
"telephone_number": "406-453-3384"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IVERS",
"first_name": "MARILYN",
"middle_name": "J",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MT",
"license": "553",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "74915",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "254150",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Great Falls, MT
- Innovative Pain Management Clinic, Inc
- Intermountain Planned Parenthood (Planned Parenthood of Montana)
- Kylie Jacqueline Irish, PTA
- Isf Lodge Montana (The Lodge Senior Living)
- Brian Itoh, MS OTR
- Sheldon G. Ivers, DDS
- Jamey Lynn Ivey, LCPC
- Ivy at Great Falls LLC
- J Flair Wellness (Great Falls Health & Wellness)
- Luke Jarvis Jackson, CRNA
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.