| Middle Cottonwood Counseling Inc | |
|
2135 Charlotte St Ste 2 Bozeman MT 59718-2741 | |
| (408) 482-2539 | |
| Not Available |
| Full Name | Middle Cottonwood Counseling Inc |
|---|---|
| Speciality | Social Worker |
| Location | 2135 Charlotte St Ste 2, Bozeman, Montana |
| Authorized Official Name and Position | Jessica Lenneman (OWNER) |
| Authorized Official Contact | 4084822539 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Middle Cottonwood Counseling Inc 8104 Pinion Pl Bozeman MT 59718-8344 Ph: (408) 482-2539 | Middle Cottonwood Counseling Inc 2135 Charlotte St Ste 2 Bozeman MT 59718-2741 Ph: (408) 482-2539 |
| NPI Number | 1689287708 |
|---|---|
| Provider Enumeration Date | 08/28/2020 |
| Last Update Date | 04/26/2021 |
| Certification Date | 04/26/2021 |
| Medicare PECOS PAC ID | 5395144356 |
|---|---|
| Medicare Enrollment ID | O20210524001596 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689287708 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Jessica Lee Pierzina Lenneman |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366513665 PECOS PAC ID: 7416263017 Enrollment ID: I20150827001031 |
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