Individual provider Active NPI

Marie Christine Pettit, LCPC

  • Professional Counselor
  • Missoula, MT
National Provider Identifier
1720601701
Registry record updated May 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
BBH-LCPC-LIC-42893 Issued in MT
Practice address
700 SW Higgins Ave Ste 107
Missoula, MT 59803-1489
Phone
(406) 531-3948
NPI assigned
May 25, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X BBH-LCPC-LIC-42893 MT
Mental Health Counselor 101YM0800X BBH-LCPC-LIC-42893 MT
Professional Counselor 101YP2500X BBH-LCPC-LIC-42893 MT Primary

Addresses

Primary practice location

700 SW Higgins Ave Ste 107
Missoula, MT 59803-1489

Mailing address

2120 S Reserve St # 1020
Missoula, MT 59801-6451
Phone (406) 531-3948

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240913002819 MT Practitioner - Mental Health Counselor 2163830555 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Little Sunflower Counseling, LLC Counselor CurrentSince Jul 1, 2020 Accepting new patients

Locations

2120 S Reserve St
Missoula, MT 59801
Phone (406) 543-1929

700 SW Higgins Ave
Ste 107
Missoula, MT 59803
Phone (406) 214-3810

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590364800000",
    "number": "1720601701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 S RESERVE ST # 1020",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016451",
            "telephone_number": "406-531-3948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 SW HIGGINS AVE STE 107",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031489",
            "telephone_number": "406-531-3948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "MARIE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-25",
        "last_updated": "2020-05-25",
        "certification_date": "2020-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MT",
            "license": "BBH-LCPC-LIC-42893",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-LCPC-LIC-42893",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "BBH-LCPC-LIC-42893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.