CMC REHAB DEPT NEUROPSYCH EVALUATIONS (NPI# 1720216005) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720216005 |
| Entity Type | Organization |
| Organization Name | CMC REHAB DEPT NEUROPSYCH EVALUATIONS |
| Practice Address |
2827 Fort Missoula Rd Missoula MT 59804-7408 |
| Practice Telephone | 4067284100 |
| Practice Fax Number | 4063274545 |
| Mailing Telephone | 4067284100 |
| Mailing Fax Number | 4063274545 |
| Enumeration Date | 2009-06-25 |
| Last Update Date | 2009-06-25 |
| Authorized Official Name | STEPHANE G CARLSON (CEO) |
| Authorized Official Telephone | 4067284100 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103T00000X | Psychologist | 226 | MT | Behavioral Health & Social Service Providers |
| Street Address |
2827 FORT MISSOULA RD |
| City | MISSOULA |
| State | MT |
| Zip Code | 59804-7408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073597639 | Vern Hicks Horton | Surgery | 2827 Fort Missoula Rd, Community Medical Center, Missoula, MT 59804-7408 | 2005-12-06 |
| 1922612431 | Jaala M Wickman | Student in an Organized Health Care Education/Training Program | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-09-02 |
| 1679193551 | Jared Hartley | Physical Therapist | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-04-21 |
| 1316567332 | Pat Roosa | Physical Therapist | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-04-20 |
| 1033739123 | Sarah Elliott | Speech-Language Pathologist | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-04-20 |
| 1578183836 | Evelyn M Redfern | Physical Therapist | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-04-16 |
| 1811517196 | Rebeccah Tye Mcmillan | Physical Therapist | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-04-16 |
| 1447888557 | Bryann Lea Bausch | Social Worker | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-04-01 |
| 1528694684 | Kate Elizabeth Berry | Nurse Practitioner | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2020-03-19 |
| 1316583511 | Hospitalist Medicine Physicians of California - Tcs, PC | Internal Medicine | 2827 Fort Missoula Rd, Missoula, MT 59804-7408 | 2019-11-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063019297 | Momentum Speech Therapy, PC | Speech-Language Pathologist | 9885 O'brien Creek Road, Missoula, MT 59804 | 2020-10-01 |
| 1033633037 | Marissa Clark | Genetic Counselor, MS | 2827 Fort Missoula Rd., Suite 317, Missoula, MT 59804 | 2017-08-01 |
| 1104295245 | Scott Richter | Specialist/Technologist | 2892 Ringo Dr, Missoula, MT 59804 | 2015-09-18 |
| 1467860353 | Zachary Ueland | Pharmacist | 4000 Highway 93 South, Missoula, MT 59804 | 2014-07-24 |
| 1316378185 | Tracy Laurel Brothers | Counselor | 1305 Wyoming Street, Missoula, MT 59804 | 2013-12-04 |
| 1447683651 | Granite Pharmacy Missoula, LLC | Durable Medical Equipment & Medical Supplies | 2230 27th Ave. West, Suite 2, Missoula, MT 59804 | 2013-08-12 |
| 1871843953 | Autum Emerson Howell | Nurse Practitioner | 2831 Ft. Missoula Rd. Bldg 2, 102, Missoula, MT 59804 | 2012-09-14 |
| 1821353939 | Carlyn Doyle | Nurse Practitioner | 2835 Fort Missoula Rd Ste 203, Missoula, MT 59804 | 2012-07-05 |
| 1396011961 | Patricia Jean Evans | Internal Medicine | 702 S.w. Higgins, First Choice Medical Clinic, Missoula, MT 59804 | 2012-03-28 |
| 1205126794 | Pacific Medical, Inc. | Prosthetic/Orthotic Supplier | 2732 South Ave West, Suite 202, Missoula, MT 59804 | 2011-04-18 |
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| Taxonomy Code | 103T00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public. |
| Notes: Source: American Psychological Association [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790341998 | Laura Lopach, LLC | Psychologist | 118 W Sussex Ave, Missoula, MT 59801-6845 | 2019-05-13 |
| 1598234239 | Edward Lesofski | Psychologist | 400 Expressway Ste D, Missoula, MT 59808-1536 | 2018-11-23 |
| 1265760797 | Melissa Neff | Psychologist | 3700 S Russell St Ste B110, Missoula, MT 59801 | 2009-11-20 |
| 1659523843 | Casey Nicole Ruggiero | Psychologist | 210 N Higgins Ave # 324, Missoula, MT 59802-4462 | 2008-10-21 |
| 1972623411 | Timothy D. Berry | Psychologist | 2831 Fort Missoula Rd Ste 106, Missoula, MT 59804-7427 | 2007-03-29 |
| 1558414920 | Michael Joseph Scolatti | Psychologist | 49 Darlene Dr, Missoula, MT 59801-1312 | 2007-01-19 |
| 1669529921 | Jennifer Hope Leight | Psychologist | 1400 Council Way, Missoula, MT 59808-1206 | 2007-01-05 |
| 1235298837 | Coe Ann Dolven | Psychologist | 101 East Broadway, Suite 310, Missoula, MT 59802 | 2006-12-08 |
| 1891875464 | Kevin Brian Dohr | Psychologist | 128 S 6th St W, Missoula, MT 59801-4031 | 2006-10-17 |
| 1699862672 | J. William Cook | Psychologist | T-214 Fort Missoula, Missoula, MT 59804-7209 | 2006-10-09 |
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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.