Active NPI
Gracia L Schall, MS LCPC
- Clinical Psychologist
- Missoula, MT
National Provider Identifier
1710950571
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 55 LCPC
- Practice address
- 1640 South Avenue West
Missoula, MT 59801 - Phone
- (406) 721-1774
- Fax
- (406) 721-1774
- NPI assigned
- Feb 10, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 55 LCPC | MT | Primary |
Addresses
Primary practice location
1640 South Avenue West
Missoula, MT 59801
Mailing address
1640 South Ave W
Missoula, MT 59801-7804
Phone (406) 721-1774
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0257074 | Medicaid | MT | |
| 075310 | Other | MT | BLUE CROSS |
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 55 LCPC | MT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1139529600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1710950571",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1640 SOUTH AVE W",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598017804",
"telephone_number": "406-721-1774",
"fax_number": "406-721-1774"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1640 SOUTH AVENUE WEST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "59801",
"telephone_number": "406-721-1774",
"fax_number": "406-721-1774"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHALL",
"first_name": "GRACIA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "MS LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-10",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MT",
"license": "55 LCPC",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0257074",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "075310",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.