Active NPI
Wahlberg Psychology Office, PC
- Community/Behavioral Health Agency
- Missoula, MT
National Provider Identifier
1912359639
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- License
- 109
- Legal business name
- WAHLBERG PSYCHOLOGY OFFICE, PC
- Practice address
- 2831 Fort Missoula Rd
Suite 201
Missoula, MT 59804-7419 - Phone
- (406) 728-8818
- NPI assigned
- Jul 6, 2016
- Organization subpart
- Yes
- Parent organization
- WAHLBERG PSYCHOLOGY OFFICE, PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. James Lee Wahlberg, PH.D
- Title
- Owner
- Phone
- (406) 728-8818
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 109 | MT | Primary |
Addresses
Primary practice location
2831 Fort Missoula Rd
Suite 201
Missoula, MT 59804-7419
Mailing address
2831 Fort Missoula Rd
Suite 201
Missoula, MT 59804-7419
Phone (406) 728-8818
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51670 | Other | MT | BLUE CROSS BLUE SHIELD |
| 492596 | Medicaid | MT |
Other names 1
- James Wahlberg, Ph.D.
National Provider Directory
National Provider Directory- Part of
- Wahlberg Psychology Office
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1467763200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1467763200000",
"number": "1912359639",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2831 FORT MISSOULA RD",
"address_2": "SUITE 201",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598047419",
"telephone_number": "406-728-8818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2831 FORT MISSOULA RD",
"address_2": "SUITE 201",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598047419",
"telephone_number": "406-728-8818"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAHLBERG PSYCHOLOGY OFFICE, PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "WAHLBERG PSYCHOLOGY OFFICE, PC",
"enumeration_date": "2016-07-06",
"last_updated": "2016-07-06",
"status": "A",
"authorized_official_last_name": "WAHLBERG",
"authorized_official_first_name": "JAMES",
"authorized_official_middle_name": "LEE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "406-728-8818",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PH.D"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": "MT",
"license": "109",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "51670",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "492596",
"state": "MT"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "James Wahlberg, Ph.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.