Providence Health & Services Mt
NPI 1558530683ActiveOrganization· Nurse Practitioner, Psych/Mental Health· Missoula, MT
Nurse Practitioner, Psych/Mental Health in Missoula, Montana, registered in NPPES in February 2008, part of Providence Health & Services Mt. The authorized official on file is Donald W. Anderson, Assistant Secretary Enrollment.
Overview
| NPI | 1558530683 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Providence Health & Services Mt |
| NPI issued | Feb 22, 2008 |
| Last updated in NPPES | Sep 17, 2026 |
| Certified by provider | Sep 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Psych/Mental Health Primary | 363LP0808X | 17652 | MT |
| Social Worker, Clinical | 1041C0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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