Organization Active NPI

Jayne Rosso Seabrook Counseling, LLC

  • Clinical Social Worker
  • Missoula, MT
National Provider Identifier
1821587304
Registry record updated May 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
BBH-LCSW-LIC-12361 Issued in MT
Legal business name
JAYNE ROSSO SEABROOK COUNSELING, LLC
Practice address
800 Kensington Ave Ste LL2
Missoula, MT 59801-5670
Phone
(406) 360-3730
NPI assigned
May 9, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2018

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

Authorized official

Name
Jayne Rosso Seabrook, LCSWNPI 1689040552
Title
Licensed Clinical Social Worker
Phone
(406) 360-3730

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 Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X BBH-LCSW-LIC-12361 MT Primary

Addresses

Primary practice location

800 Kensington Ave Ste LL2
Missoula, MT 59801-5670

Mailing address

PO Box 3453
Missoula, MT 59806-3453
Phone (406) 360-3730

Other identifiers 1

IdentifierTypeStateIssuer
5C0F57BA44MedicaidMT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180601001711 MT Part B Supplier - Clinic/Group Practice 4789949306 Receives reassigned benefits from 1 practitioner
Practice locations: Missoula, MT

National Provider Directory

National Provider Directory

Locations

800 Kensington Ave
Ste LL2
Missoula, MT 59801
Phone (406) 360-3730

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525824000000",
    "number": "1821587304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3453",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598063453",
            "telephone_number": "406-360-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 KENSINGTON AVE STE LL2",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598015670",
            "telephone_number": "406-360-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAYNE ROSSO SEABROOK COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2018-05-09",
        "status": "A",
        "authorized_official_last_name": "SEABROOK",
        "authorized_official_first_name": "JAYNE",
        "authorized_official_middle_name": "ROSSO",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "406-360-3730",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-12361",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5C0F57BA44",
            "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 May 9, 2018; 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.