MICHAEL WAYNE HETHERINGTON


Address: 4255 Kimberwicke St, Bozeman, MT 59718-5700
Phone: 4065226300

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).

Provider Overview

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

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
MT 1477745370 05

Office Location

Street Address 4255 KIMBERWICKE ST
City BOZEMAN
State MT
Zip Code 59718-5700

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NPI Name Taxonomy Address Enumeration
1932727518 Alex Mattucci Pharmacist 200 South 23rd St, Bozeman, MT 59718 2020-07-09
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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
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Taxonomy Information

Taxonomy Code 101YM0800X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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

Competitor

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City BOZEMAN
Zip Code 59718

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Dataset Information

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.

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