| Hettie Jans Wortelboer Pllc | |
|
215 E Lewis St Ste 100 Livingston MT 59047-3144 | |
| (406) 223-0206 | |
| Not Available |
| Full Name | Hettie Jans Wortelboer Pllc |
|---|---|
| Speciality | Counselor |
| Location | 215 E Lewis St Ste 100, Livingston, Montana |
| Authorized Official Name and Position | Hettie Jans Wortelboer (OWNER) |
| Authorized Official Contact | 4062230206 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hettie Jans Wortelboer Pllc 215 E Lewis St Ste 100 Livingston MT 59047-3144 Ph: (406) 223-0206 | Hettie Jans Wortelboer Pllc 215 E Lewis St Ste 100 Livingston MT 59047-3144 Ph: (406) 223-0206 |
| NPI Number | 1891561759 |
|---|---|
| Provider Enumeration Date | 11/30/2023 |
| Last Update Date | 11/30/2023 |
| Certification Date | 11/30/2023 |
| Medicare PECOS PAC ID | 6406293448 |
|---|---|
| Medicare Enrollment ID | O20240326001709 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891561759 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
| Provider Name | Hettie Jans Wortelboer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417019027 PECOS PAC ID: 1850738899 Enrollment ID: I20240326001812 |
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