| Stacey De Witt Lcpc Llc (stacey M De Witt Sole Mbr) | |
|
725 W Alder St Ste 10 Missoula MT 59802-4099 | |
| (406) 529-5121 | |
| Not Available |
| Full Name | Stacey De Witt Lcpc Llc (stacey M De Witt Sole Mbr) |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 725 W Alder St Ste 10, Missoula, Montana |
| Authorized Official Name and Position | Stacey M De Witt (OWNER/THERAPIST) |
| Authorized Official Contact | 4065295121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stacey De Witt Lcpc Llc (stacey M De Witt Sole Mbr) Po Box 134 Lolo MT 59847-0134 Ph: (406) 529-5121 | Stacey De Witt Lcpc Llc (stacey M De Witt Sole Mbr) 725 W Alder St Ste 10 Missoula MT 59802-4099 Ph: (406) 529-5121 |
| NPI Number | 1003657131 |
|---|---|
| Provider Enumeration Date | 06/03/2024 |
| Last Update Date | 06/03/2024 |
| Certification Date | 06/03/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003657131 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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