Missoula Family Therapy, LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

SWPLCPCLIC4670 Issued in MT

Legal business name

MISSOULA FAMILY THERAPY, LLC

Practice address

110 E Broadway St Ste 204
Missoula, MT 59802-4592

Phone

(406) 370-4664

NPI assigned

Nov 27, 2013

Last updated

Jan 15, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Stacy Jennings, M.S.NPI 1437571007

Title

LMFT, LCPC

Phone

(406) 370-4664

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stacy Jennings

  • Professional Counselor
  • Missoula, MT
  • NPI 1437571007
  NPD (past) Authorized official

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

{
    "created_epoch": "1385510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1750712808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E BROADWAY ST STE 204",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024592",
            "telephone_number": "406-370-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 E BROADWAY ST STE 204",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024592",
            "telephone_number": "406-370-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSOULA FAMILY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-27",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "JENNINGS",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "LMFT, LCPC",
        "authorized_official_telephone_number": "406-370-4664",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "SWPLCPCLIC4670",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Missoula, MT
• Providers in Missoula, MT by specialty
• Professional Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.