| Family Counseling Center Of Mt | |
|
145 Mill Town Loop Ste B Bozeman MT 59718-5144 | |
| (406) 219-1350 | |
| Not Available |
| Full Name | Family Counseling Center Of Mt |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 145 Mill Town Loop Ste B, Bozeman, Montana |
| Authorized Official Name and Position | Amanda Jane Fahlstrom (OWNER/CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4062191350 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Counseling Center Of Mt Po Box 7003 Bozeman MT 59771-7003 Ph: (406) 219-1350 | Family Counseling Center Of Mt 145 Mill Town Loop Ste B Bozeman MT 59718-5144 Ph: (406) 219-1350 |
| NPI Number | 1811572647 |
|---|---|
| Provider Enumeration Date | 03/12/2021 |
| Last Update Date | 04/24/2021 |
| Certification Date | 04/24/2021 |
| Medicare PECOS PAC ID | 2264835172 |
|---|---|
| Medicare Enrollment ID | O20210728004207 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811572647 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Amanda Jane Fahlstrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962061887 PECOS PAC ID: 3971926726 Enrollment ID: I20200713000698 |
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