Organization Active NPI

Dr. John J Siefke Psychological Services PLLC

  • Clinical Psychologist
  • Bozeman, MT
National Provider Identifier
1902620115
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DR. JOHN J SIEFKE PSYCHOLOGICAL SERVICES PLLC
Practice address
1902 W Dickerson St Ste 208
Bozeman, MT 59718-6852
Phone
(406) 295-6899
NPI assigned
Nov 13, 2024
Last updated
Nov 13, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Authorized official

Name
Dr. John Siefke, PH.D.NPI 1548901853
Title
Psychologist
Phone
(406) 295-6899

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 Psychologist 103TC0700X NU Primary

Addresses

Primary practice location

1902 W Dickerson St Ste 208
Bozeman, MT 59718-6852

Mailing address

1902 W Dickerson St Ste 208
Bozeman, MT 59718-6852

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250131001092 MT Part B Supplier - Clinic/Group Practice 7214462522 Receives reassigned benefits from 1 practitioner
Practice locations: Bozeman, MT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1731456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731456000000",
    "number": "1902620115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1902 W DICKERSON ST STE 208",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1902 W DICKERSON ST STE 208",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597186852",
            "telephone_number": "406-295-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOHN J SIEFKE PSYCHOLOGICAL SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-13",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A",
        "authorized_official_last_name": "SIEFKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PSYCHOLOGIST",
        "authorized_official_telephone_number": "406-295-6899",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "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 13, 2024; 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.