Extraordinary Distances

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

EXTRAORDINARY DISTANCES

Practice address

178 W Lyndale Ave
Helena, MT 59601-2822

Phone

(406) 443-2455

NPI assigned

Jan 21, 2020

Organization subpart

No

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

Authorized official

Name

Erica H. Durham, CBHPSS

Title

Principal

Phone

(406) 443-2455

Specialties & licenses 2

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579564800000",
    "number": "1841820669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 W LYNDALE AVE",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596012822",
            "telephone_number": "406-443-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 W LYNDALE AVE",
            "city": "HELENA",
            "state": "MT",
            "postal_code": "596012822",
            "telephone_number": "406-443-2455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXTRAORDINARY DISTANCES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-21",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "H.",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "406-443-2455",
        "authorized_official_credential": "CBHPSS"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Recovery Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Helena",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Helena",
            "address_1": "178 W Lyndale Ave",
            "city": "Helena",
            "state": "MT",
            "country_code": "US",
            "postal_code": "596012822",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Justin Evans, LCSW
• Kaydee Evans
• Sarah Elizabeth Evans, M.D.
• Tiffany Ann Evans, LCPC
• William Spencer Evans, MSW LCSW BCD
• Melissa Faber
• Anthony Scott Fabian, PHARMD
• John Fabra
• Jeannie Marlene Fahlquist, NP-C
• Leigh Fahlquist

• Community/Behavioral Health Agency in Helena, MT
• Providers in Helena, MT by specialty
• Community/Behavioral Health Agency in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.