Western Pine Psychotherapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

WESTERN PINE PSYCHOTHERAPY LLC

Practice address

2100 S Higgins Ave
Missoula, MT 59801-6761

Phone

(406) 546-1745

NPI assigned

Apr 9, 2019

Organization subpart

No

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

Authorized official

Name

Emilie Burke, LCSWNPI 1649754714

Title

Owner, Clinical Social Worker

Phone

(406) 546-1745

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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.

• Emilie Burke

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1649754714
  Medicare reassignment NPD Authorized official
• Shanico Allen Christopher, SWLC

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1811735251
  NPD
• Sarah Jane Trueax, LCSW

  • Clinical Social Worker
  • McMinnville, OR
  • NPI 1558870808
  NPD (past)

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

{
    "created_epoch": "1554768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554768000000",
    "number": "1750844478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2617 GARLAND DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598032009",
            "telephone_number": "406-546-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S HIGGINS AVE",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598016761",
            "telephone_number": "406-546-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTERN PINE PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-09",
        "last_updated": "2019-04-09",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "EMILIE",
        "authorized_official_title_or_position": "OWNER, CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "406-546-1745",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MONTANA BUSINESS STANDARDS DIVISION BOARD OF BEHAVIORAL HEALTH",
            "identifier": "BBH-LCSW-LIC-32067",
            "state": "MT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "eburke@therapysecure.com",
            "affiliation": "N",
            "endpointDescription": "HIPAA compliant profession email",
            "address_1": "2100 S Higgins Ave",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598016761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Western Montana Mental Health Center
• Western Montana Mental Health Center
• Western Montana Mental Health Center
• Western Montana Orthotics & Prosthetics, P.C.
• Western Montana Spine & Injury Clinic PLLC
• Western Skies Behavioral Health, LLC
• Western States Infectious Diseases PC
• Michela Ann Westhoff, PA-C
• Mark Weston, M.D.
• David Westphal, MD

• Clinical Social Worker in Missoula, MT
• Providers in Missoula, 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 Apr 9, 2019; 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.