Active NPI
Susan Jedd
- Counselor
- Bozeman, MT
National Provider Identifier
1972933018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- SWP-LCPC-LIC-4668
- Practice address
- 2050 Fairway Dr
Suite 202
Bozeman, MT 59715-5806 - Phone
- (406) 223-5480
- NPI assigned
- Nov 26, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | SWP-LCPC-LIC-4668 | MT | Primary |
Addresses
Primary practice location
2050 Fairway Dr
Suite 202
Bozeman, MT 59715-5806
Mailing address
2050 Fairway Dr
Suite 202
Bozeman, MT 59715-5806
Phone (406) 223-5480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
1001 W Oak St
Suite 205
Bozeman, MT 59715-8757
Phone (480) 869-2826
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| SWP-LCPC-LIC-4668 | MT | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ncenter, LLC | Current | Accepting new patients |
Locations
1001 W Oak St
Ste 205
Bozeman, MT 59715
Phone (406) 581-1138
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Mental Health Counselor
- Bozeman, MT
- NPI 1124435730
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385424000000",
"number": "1972933018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2050 FAIRWAY DR",
"address_2": "SUITE 202",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597155806",
"telephone_number": "406-223-5480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2050 FAIRWAY DR",
"address_2": "SUITE 202",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597155806",
"telephone_number": "406-223-5480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEDD",
"first_name": "SUSAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-26",
"last_updated": "2013-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MT",
"license": "SWP-LCPC-LIC-4668",
"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 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.