Individual provider Active NPI

Zachary Edwards, PCLC

  • Mental Health Counselor
  • Bozeman, MT
National Provider Identifier
1841065893
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
BBH-PCLC-LIC-64872 Issued in MT
Practice address
89 Annie Glade Dr
Bozeman, MT 59718-9149
Phone
(406) 581-2459
NPI assigned
Nov 20, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X BBH-PCLC-LIC-64872 MT Primary

Addresses

Primary practice location

89 Annie Glade Dr
Bozeman, MT 59718-9149

Mailing address

89 Annie Glade Dr
Bozeman, MT 59718-9149
Phone (406) 581-2459

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
BBH-PCLC-LIC-64872MTMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1841065893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "89 ANNIE GLADE DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597189149",
            "telephone_number": "406-581-2459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 ANNIE GLADE DR",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597189149",
            "telephone_number": "406-581-2459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "ZACHARY",
        "credential": "PCLC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "BBH-PCLC-LIC-64872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.