| Ponderosa Counseling And Therapeutic Services, Llc | |
|
209 S Central Ave Rm 304 White Sulphur Springs MT 59645-9086 | |
| (406) 640-3242 | |
| Not Available |
| Full Name | Ponderosa Counseling And Therapeutic Services, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 209 S Central Ave Rm 304, White Sulphur Springs, Montana |
| Authorized Official Name and Position | Kyle Jacobsen (OWNER) |
| Authorized Official Contact | 4066403242 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ponderosa Counseling And Therapeutic Services, Llc Po Box 802 White Sulphur Springs MT 59645-1802 Ph: (406) 640-3242 | Ponderosa Counseling And Therapeutic Services, Llc 209 S Central Ave Rm 304 White Sulphur Springs MT 59645-9086 Ph: (406) 640-3242 |
| NPI Number | 1700403243 |
|---|---|
| Provider Enumeration Date | 07/01/2020 |
| Last Update Date | 03/24/2022 |
| Certification Date | 03/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700403243 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |