| Yellowstone Psychotherapy | |
|
124 S Main St Apt 212 Livingston MT 59047-2664 | |
| (406) 224-0727 | |
| Not Available |
| Full Name | Yellowstone Psychotherapy |
|---|---|
| Speciality | Psychologist |
| Location | 124 S Main St Apt 212, Livingston, Montana |
| Authorized Official Name and Position | Rachel Jergenson (OWNER) |
| Authorized Official Contact | 4062240727 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yellowstone Psychotherapy 124 S Main St Apt 212 Livingston MT 59047-2664 Ph: (406) 224-0727 | Yellowstone Psychotherapy 124 S Main St Apt 212 Livingston MT 59047-2664 Ph: (406) 224-0727 |
| NPI Number | 1932651999 |
|---|---|
| Provider Enumeration Date | 10/25/2016 |
| Last Update Date | 10/01/2024 |
| Certification Date | 10/01/2024 |
| Medicare PECOS PAC ID | 7214218502 |
|---|---|
| Medicare Enrollment ID | O20161228001171 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932651999 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Rachel R Jergenson |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093871006 PECOS PAC ID: 0446314801 Enrollment ID: I20090129000296 |
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