Ammons Psychological Services, PLLC
Organization Active NPI Clinical Psychologist · Missoula, MT
NPI 1861694119 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1861694119
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 374 (MT)
- Legal business name
- AMMONS PSYCHOLOGICAL SERVICES, PLLC
- Practice address
- 2831 Fort Missoula Rd Ste 201
Physicians' Center #2
Missoula, MT 59804-7401 - Phone
- (406) 728-8818
- Fax
- (406) 728-8818
- NPI assigned
- May 31, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert Bruce Ammons III, PH.D.
- Title
- Clinical Psychologist-Sole Proprtr
- Phone
- (406) 728-8818
Practitioners 1
-
Robert Bruce Ammons III, PH D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070614000712 | MT | Part B Supplier - Clinic/Group Practice | 6406954494 |
Receives reassigned benefits from 1 practitioner Practice locations: Missoula, MT |
National Provider Directory
Locations
2831 Fort Missoula Rd
Ste 201
Missoula, MT 59804
Phone (406) 728-8818
1805 Bancroft St
Ste 1
Missoula, MT 59801
Phone (406) 728-8818
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist |
103TC0700X | 374 | MT | Yes |
Addresses
Primary practice location
2831 Fort Missoula Rd Ste 201
Physicians' Center #2
Missoula, MT 59804-7401
Mailing address
2831 Fort Missoula Rd Ste 201
Physicians' Center #2
Missoula, MT 59804-7401
Phone (406) 728-8818
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0057850 | Medicaid | MT |
Other providers in Missoula, MT
- Civan Altunkaynak
- April Christine Alvernaz
- Casey Ambrose
- Melanie Ames
- Rachel S Ames
- Beth Ammons
- Robert Bruce Ammons III
- Robert Yost-Arch Amrine
- Amy Friedman, LLC
- Amy Sellman PT PLLC
All providers in Missoula, MT · Clinical Psychologist in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.