Living Well, Llc | |
400 W Main St Ste 203 Hamilton MT 59840-2443 | |
(406) 363-2873 | |
Not Available |
Full Name | Living Well, Llc |
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Speciality | Social Worker |
Location | 400 W Main St Ste 203, Hamilton, Montana |
Authorized Official Name and Position | Kellie Mildenberger (OWNER/THERAPIST) |
Authorized Official Contact | 4063632873 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Living Well, Llc Po Box 1707 Hamilton MT 59840-1707 Ph: () - | Living Well, Llc 400 W Main St Ste 203 Hamilton MT 59840-2443 Ph: (406) 363-2873 |
NPI Number | 1639686462 |
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Provider Enumeration Date | 01/02/2018 |
Last Update Date | 03/28/2018 |
Medicare PECOS PAC ID | 4385903673 |
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Medicare Enrollment ID | O20180111002851 |
Identifier | Type | State | Issuer |
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1639686462 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1041C0700X | Social Worker - Clinical | BBH-LCSW-LIC-12274 (Montana) | Primary |
1041C0700X | Social Worker - Clinical | 7731-C (Nevada) | Secondary |
Provider Name | Kellie D Mildenberger |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1356726111 PECOS PAC ID: 3173838307 Enrollment ID: I20150818004635 |
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