Wake Mental Health LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WAKE MENTAL HEALTH LLC

Practice address

1077 Whitefish Stage Road
Kalispell, MT 59901-2735

Phone

(406) 253-1807

NPI assigned

Dec 30, 2020

Organization subpart

No

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

Authorized official

Name

Jill DieserNPI 1831705318

Title

LCSW

Phone

(406) 253-1807

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jill Dieser, LCSW

  • Clinical Social Worker
  • Kalispell, MT
  • NPI 1831705318
  Medicare reassignment NPD Authorized official
• Jacqueline H Stanley, PH.D.

  • Clinical Psychologist
  • Bozeman, MT
  • NPI 1407997471
  NPD (past)
• Kathryn Lloyd, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Aurora, CO
  • NPI 1538425590
  NPD (past)

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1758153600000",
    "number": "1700473253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3206",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599033206",
            "telephone_number": "406-253-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1077 WHITEFISH STAGE ROAD",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599012735",
            "telephone_number": "406-253-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKE MENTAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-30",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A",
        "authorized_official_last_name": "DIESER",
        "authorized_official_first_name": "JILL",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "406-253-1807"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Loren Stephen Vranish, M.D.
• Gina Marie Wade, C.M.T
• Peter Wagner, MD
• Amber Wagstaff, LMT, NMT
• Tyler Wagstaff
• Wal-Mart Stores, Inc (Vision Center 30-2259)
• Deanna Walcheck, MRC, CRC
• Walgreen Co (Walgreens 09242)
• Shannon Amara Walk
• Walker Wellness LLC

• Clinical Social Worker in Kalispell, MT
• Providers in Kalispell, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2025; 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.