STEPHANIE LARSON BURCUSA (NPI# 1235322421) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235322421 |
| Entity Type | Individual |
| Full Name | STEPHANIE LARSON BURCUSA |
| Credential | PHD |
| Practice Address |
400 15th Ave S Ste 205 Great Falls MT 59405-4375 |
| Practice Telephone | (406) 731-8888 |
| Practice Fax Number | 4067318876 |
| Mailing Telephone | (406) 731-8888 |
| Mailing Fax Number | 4067318876 |
| Enumeration Date | 2007-08-22 |
| Last Update Date | 2017-08-29 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
2210 | MT | Behavioral Health & Social Service Providers |
| Street Address |
400 15TH AVE S STE 205 |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59405-4375 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841291705 | Rennae I Johnson | Psychologist | 400 15th Ave S Ste 205, Great Falls, MT 59405-4375 | 2005-08-02 |
| 1932100518 | Mark H Johnson | Clinical Neuropsychologist | 400 15th Ave S Ste 205, Great Falls, MT 59405-4375 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902446180 | Reilly Kunz | Physical Therapist | 2621 15th Ave South, Great Falls, MT 59405 | 2020-01-15 |
| 1336617224 | Brandi Noel Sauer | Behavior Technician | 1601 2nd Ave North Suite 518, Great Falls, MT 59405 | 2018-11-08 |
| 1982103446 | Traci Raines Aprn Pllc | Nurse Practitioner | 120 Marillyn Dr, Great Falls, MT 59405 | 2018-02-09 |
| 1003332818 | Great Falls Health Supplies | Durable Medical Equipment & Medical Supplies | 1720 10th Ave., South, Suite 4-151, Great Falls, MT 59405 | 2017-08-15 |
| 1518489426 | Jessica Lynn Keller | Specialist/Technologist | 720 46th Street South, Great Falls, MT 59405 | 2017-07-12 |
| 1235678475 | Vanessa Claudia Hernandez | Occupational Therapist | 2621 15 Ave So, Great Falls, MT 59405 | 2017-02-21 |
| 1871039339 | Morgan Laux Olsen | Specialist/Technologist | 1301 20th St S, Great Falls, MT 59405 | 2017-01-09 |
| 1558807198 | Greg Robert Lipton | Occupational Therapist | 2621 15th Ave So, Great Falls, MT 59405 | 2017-01-06 |
| 1386180925 | Jessica Lee Krahn | Physical Therapist | 2621 15th Ave So., Great Falls, MT 59405 | 2017-01-06 |
| 1811430150 | Juli Brandvold | Massage Therapist | 2400 4th Ave S., Great Falls, MT 59405 | 2016-11-18 |
| Find all providers in zip 59405 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568523561 | Lynn Scott Johnson | Psychologist | 401 15th Ave. South, Suite 206, Great Falls, MT 59405-4334 | 2006-12-13 |
| 1841219060 | Marlene Jeanette Mowery | Psychologist | 1601 2nd Avenue North Suite 338, Columbus Center, Great Falls, MT 59401 | 2006-07-19 |
| 1508849910 | Betsy Rushworth | Psychologist | 906 7th St S, Great Falls, MT 59405-4026 | 2005-11-21 |
| 1841291705 | Rennae I Johnson | Psychologist | 400 15th Ave S Ste 205, Great Falls, MT 59405-4375 | 2005-08-02 |
| 1669963872 | Heather Marie Halko | Psychologist | 1101 26th St S, Great Falls, MT 59405-5161 | 2018-05-23 |
| 1912020249 | Michael John Mclaughlin | Psychologist | 915 1st Ave S, Center for Mental Health, Great Falls, MT 59401-3705 | 2007-04-10 |
| 1740202068 | Michael Lee Mason | Psychologist | 915 1st Ave S, Center for Mental Health, Great Falls, MT 59401-3705 | 2006-07-24 |
| 1548281769 | Kendal Chris Southall | Psychologist | 800 2nd St S, Great Falls, MT 59405-4002 | 2006-07-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275172454 | Karolyn W. Seidl | Psychologist | 124 S Main St Ste 213, Livingston, MT 59047-2664 | 2020-01-05 |
| 1578125662 | Brittni Funderburk | Psychologist | 38 E Washington St Ste D, Kalispell, MT 59901-3975 | 2019-06-28 |
| 1528523388 | Judith Margaret Firehammer | Psychologist | 37 East Main St, Suite 7, Bozeman, MT 59715 | 2019-02-06 |
| 1366907545 | Karen J. Kietzman. Psy.d., Inc. | Psychologist | 2475 Village Ln Ste 104, Billings, MT 59102-2497 | 2019-02-01 |
| 1447759873 | Katrina Kit Evans | Psychologist | 1075 N Meridian Rd Ste 200, Kalispell, MT 59901-3567 | 2018-02-12 |
| 1700390085 | Hillary Kaitlin Morin | Psychologist | 5 W Mendenhall St Ste 202, Bozeman, MT 59715-3559 | 2017-11-26 |
| 1144680844 | Bighorn Valley Health Center Incorporated | Psychologist | 1000 E. River Road, Ashland, MT 59003 | 2016-02-24 |
| 1407214968 | Kathryn Darnell | Psychologist | 502 S 19th Ave Ste 300, Bozeman, MT 59718-6810 | 2016-01-29 |
| 1316324700 | Polly Peterson | Psychologist | 125 W Granite St Ste 212, Butte, MT 59701-9215 | 2015-05-05 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| Find all providers with the same taxonomy | ||||
| City | GREAT FALLS |
| Zip Code | 59405 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.