| Lily Gervais Lcsw, Lac Pllc | |
|
5767 W Harrier Dr Missoula MT 59808-1053 | |
| (406) 546-9257 | |
| Not Available |
| Full Name | Lily Gervais Lcsw, Lac Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 5767 W Harrier Dr, Missoula, Montana |
| Authorized Official Name and Position | Lily Gervais (OWNER) |
| Authorized Official Contact | 4065469257 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lily Gervais Lcsw, Lac Pllc 5767 W Harrier Dr Missoula MT 59808-1053 Ph: (406) 546-9257 | Lily Gervais Lcsw, Lac Pllc 5767 W Harrier Dr Missoula MT 59808-1053 Ph: (406) 546-9257 |
| NPI Number | 1154174837 |
|---|---|
| Provider Enumeration Date | 04/10/2024 |
| Last Update Date | 06/12/2024 |
| Certification Date | 06/12/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154174837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
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