Clark Fork Behavioral Health Inc.

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

CLARK FORK BEHAVIORAL HEALTH INC.

Practice address

913 SW Higgins Ave Ste 102
Missoula, MT 59803-1423

Phone

(406) 431-7764

Fax

(406) 493-1260

NPI assigned

Oct 25, 2023

Organization subpart

No

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

Authorized official

Name

Cody Bryant, LCPCNPI 1699197335

Title

President

Phone

(406) 431-7764

Specialties & licenses 2

Addresses

Other names 1

• Cody Bryant LCPC Inc. Former legal business name

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cody Bryant, LCPC

  • Professional Counselor
  • Missoula, MT
  • NPI 1699197335
  Medicare reassignment Authorized official
• Maureen Bryant, LCSW

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1447844220
  NPD

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

{
    "created_epoch": "1698192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698192000000",
    "number": "1801668686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 SW HIGGINS AVE STE 102",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031423",
            "telephone_number": "406-431-7764",
            "fax_number": "406-493-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "913 SW HIGGINS AVE STE 102",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598031423",
            "telephone_number": "406-431-7764",
            "fax_number": "406-493-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK FORK BEHAVIORAL HEALTH INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-25",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-25",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "406-431-7764",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cody Bryant LCPC Inc.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Nicole Marie Cirilli, BS, RD, LN
• City of Missoula
• Claire Manny Counseling LLC
• Clancy L. Cone, MD, PC
• Jordan R Clarfield, MSC, MA
• Clark Fork Dental
• Clark Fork Emergency Physicians PLLC
• Clark Fork Healthcare, LLC
• Clark Fork Healthcare, LLC
• Clark Fork Occupational Therapy

• 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 Oct 25, 2023; 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.