MICHAEL WAYNE HETHERINGTON (NPI# 1528574423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528574423 |
| Entity Type | Individual |
| Full Name | MICHAEL WAYNE HETHERINGTON |
| Credential | LCPC |
| Practice Address |
4255 Kimberwicke St Bozeman MT 59718-5700 |
| Mailing Address |
2472 Lasso Ave Bozeman MT 59718-8039 |
| Practice Telephone | 4065226300 |
| Mailing Telephone | 4065704692 |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2018-06-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
BBH-LCPC-LIC-261 | MT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 1477745370 | 05 |
| Street Address |
4255 KIMBERWICKE ST |
| City | BOZEMAN |
| State | MT |
| Zip Code | 59718-5700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932727518 | Alex Mattucci | Pharmacist | 200 South 23rd St, Bozeman, MT 59718 | 2020-07-09 |
| 1285251132 | West Bozeman Surgery Center, LLC | Clinic/Center | 5031 S. Cottonwood Road, Suite 100, Bozeman, MT 59718 | 2020-06-26 |
| 1528680733 | Amanda Harris | Student in an Organized Health Care Education/Training Program | 301 Edelweiss Dr, Unit 7, Bozeman, MT 59718 | 2020-05-11 |
| 1568946291 | Build Physio & Performance, Pllc | Physical Therapist | 609 Pronghorn Trail, Bozeman, MT 59718 | 2018-09-19 |
| 1184107872 | Hunter Family Chiropractic Pllc | Chiropractor | 37 Spanish Peak Drive, Bozeman, MT 59718 | 2018-09-10 |
| 1588179873 | Melissa N Blixt | Nurse Practitioner | 1805 W. Oak, Bozeman, MT 59718 | 2017-12-07 |
| 1861949455 | Kristina Joy Parmelee | Massage Therapist | 1001 West Oak Street #210, Bozeman, MT 59718 | 2016-09-01 |
| 1265883037 | Molly Kathleen Smith | Specialist | 642 S. Cottonwood Rd., Suite 2, Bozeman, MT 59718 | 2016-06-23 |
| 1063891414 | Dutton & Willhite, Inc. | Chiropractor | 2622 W. Main Ste. B, Bozeman, MT 59718 | 2015-05-19 |
| 1548664253 | Stacy Montaigne Aucoin | Social Worker | 102 S. 19th, Suite #5, Bozeman, MT 59718 | 2014-10-09 |
| Find all providers in zip 59718 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073112520 | Autumn R Clowes | Counselor | 20 Arrowhead Trl, Bozeman, MT 59718-9452 | 2020-10-25 |
| 1043824683 | Jacqueline Bence | Counselor | 2246 Boot Hill Ct # 3, Bozeman, MT 59715-7248 | 2020-09-01 |
| 1851902423 | Danielle Josephine Stack | Counselor | 2115 Durston Rd Ste 10, Bozeman, MT 59718-2800 | 2020-08-16 |
| 1700496338 | Emily M Tage | Counselor | 2417 W Main St Ste 2, Bozeman, MT 59718-3811 | 2020-08-07 |
| 1629686811 | Terese E Jeppson | Counselor | 1103 S Willson Ave, Bozeman, MT 59715-5248 | 2020-07-14 |
| 1700413366 | Brooke Sibary | Counselor | 1609 W Babcock St Ste A, Bozeman, MT 59715-4018 | 2020-03-24 |
| 1922658889 | Amanda Lynn Kuehn Forney | Counselor | 601 Nikles Dr Ste 12, Bozeman, MT 59715-2570 | 2019-09-12 |
| 1538728043 | Joanna Wright | Counselor | 1195 Stoneridge Dr # 4a-b, Bozeman, MT 59718-7048 | 2019-06-08 |
| 1194280875 | Erica Kotick | Counselor | 2246 Boot Hill Court, Suite 4, Bozeman, MT 59715 | 2019-02-06 |
| 1821515925 | Sheri Lee Mortensen-blackwood | Counselor | 2505 Fairway Drive, Bozeman, MT 59715 | 2017-08-29 |
| Find all providers in BOZEMAN | ||||
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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.