Organization Active NPI

Hallie Bornstein Banziger PHD LLC

  • Clinical Psychologist
  • Missoula, MT
National Provider Identifier
1801062096
Registry record updated Oct 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
366 Issued in MT
Legal business name
HALLIE BORNSTEIN BANZIGER PHD LLC
Practice address
125 Bank St
Suite 310
Missoula, MT 59802-4407
Phone
(406) 549-7325
NPI assigned
May 7, 2008
Last updated
Oct 22, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2008

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

Authorized official

Name
Hallie Alyssa Bornstein Banziger, PHDNPI 1326197906
Title
Owner
Phone
(406) 219-3311

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 366 MT Primary

Addresses

Primary practice location

125 Bank St
Suite 310
Missoula, MT 59802-4407

Mailing address

935 Highland Blvd
Suite 4400
Bozeman, MT 59715-6904
Phone (406) 219-3311

Other identifiers 1

IdentifierTypeStateIssuer
52501OtherMTBLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081015000013 MT Part B Supplier - Clinic/Group Practice 1951469253 Receives reassigned benefits from 1 practitioner
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Locations

935 Highland Blvd
Ste 4400
Bozeman, MT 59715
Phone (406) 587-5123

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1801062096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "935 HIGHLAND BLVD",
            "address_2": "SUITE 4400",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597156904",
            "telephone_number": "406-219-3311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 BANK ST",
            "address_2": "SUITE 310",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024407",
            "telephone_number": "406-549-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALLIE BORNSTEIN BANZIGER PHD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "BORNSTEIN BANZIGER",
        "authorized_official_first_name": "HALLIE",
        "authorized_official_middle_name": "ALYSSA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-219-3311",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MT",
            "license": "366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "52501",
            "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 Oct 22, 2008; 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.