Organization Active NPI

Hettie Jans Wortelboer PLLC

  • Professional Counselor
  • Livingston, MT
National Provider Identifier
1891561759
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
HETTIE JANS WORTELBOER PLLC
Practice address
215 E Lewis St Ste 100
Livingston, MT 59047-3144
Phone
(406) 223-0206
NPI assigned
Nov 30, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Hettie Jans Wortelboer
Title
Owner
Phone
(406) 223-0206

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

215 E Lewis St Ste 100
Livingston, MT 59047-3144

Mailing address

215 E Lewis St Ste 100
Livingston, MT 59047-3144
Phone (406) 223-0206

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240326001709 MT Part B Supplier - Clinic/Group Practice 6406293448 Receives reassigned benefits from 1 practitioner
Practice locations: Livingston, MT

National Provider Directory

National Provider Directory

Locations

215 E Lewis St
Ste 100
Livingston, MT 59047
Phone (406) 223-0206

Practitioners & affiliated clinicians

Practitioners 2

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": "1701302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1891561759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E LEWIS ST STE 100",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590473144",
            "telephone_number": "406-223-0206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E LEWIS ST STE 100",
            "city": "LIVINGSTON",
            "state": "MT",
            "postal_code": "590473144",
            "telephone_number": "406-223-0206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HETTIE JANS WORTELBOER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-30",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "WORTELBOER",
        "authorized_official_first_name": "HETTIE",
        "authorized_official_middle_name": "JANS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-223-0206"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livingston, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.