Active NPI
Rebecca L Koltz, PH.D, LCPC, NCC
- Mental Health Counselor
- Bozeman, MT
National Provider Identifier
1972704625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1481 - LCPC
- Practice address
- 714 Stoneridge Dr
Suite 2
Bozeman, MT 59718-7046 - Phone
- (406) 580-4452
- Fax
- (406) 582-5717
- NPI assigned
- May 30, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | LPC3753 | ID | |
| Mental Health Counselor | 101YM0800X | 1481 - LCPC | MT | Primary |
Addresses
Primary practice location
714 Stoneridge Dr
Suite 2
Bozeman, MT 59718-7046
Mailing address
438 Woodman Dr
Belgrade, MT 59714-7243
Phone (406) 580-4452
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC3753 | ID | MD | Mental Health Counselor |
| 1481 - LCPC | MT | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334016000000",
"number": "1972704625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "438 WOODMAN DR",
"city": "BELGRADE",
"state": "MT",
"postal_code": "597147243",
"telephone_number": "406-580-4452",
"fax_number": "406-582-5717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 STONERIDGE DR",
"address_2": "SUITE 2",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597187046",
"telephone_number": "406-580-4452",
"fax_number": "406-582-5717"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOLTZ",
"first_name": "REBECCA",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PH.D, LCPC, NCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-30",
"last_updated": "2012-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ID",
"license": "LPC3753",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MT",
"license": "1481 - LCPC",
"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 Apr 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.