Active NPI
Leif Hallberg, LCPC
- Mental Health Counselor
- Bozeman, MT
National Provider Identifier
1750617049
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- BBH-LCPC-LIC-12379
- Practice address
- 416 N Ida Ave
Bozeman, MT 59715-3016 - Phone
- (406) 600-2004
- NPI assigned
- Oct 22, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | C2986 | OR | |
| Mental Health Counselor | 101YM0800X | BBH-LCPC-LIC-12379 | MT | Primary |
Addresses
Primary practice location
416 N Ida Ave
Bozeman, MT 59715-3016
Mailing address
416 N Ida Ave
Bozeman, MT 59715-3016
Phone (406) 600-2004
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 |
|---|---|---|---|
| BBH-LCPC-LIC-12379 | MT | MD | Mental Health Counselor |
| C2986 | OR | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462320000000",
"number": "1750617049",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "416 N IDA AVE",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597153016",
"telephone_number": "406-600-2004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "416 N IDA AVE",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597153016",
"telephone_number": "406-600-2004"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HALLBERG",
"first_name": "LEIF",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-22",
"last_updated": "2016-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "OR",
"license": "C2986",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MT",
"license": "BBH-LCPC-LIC-12379",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.