| Western Pine Psychotherapy Llc | |
|
2100 S Higgins Ave Missoula MT 59801-6761 | |
| (406) 546-1745 | |
| Not Available |
| Full Name | Western Pine Psychotherapy Llc |
|---|---|
| Speciality | Social Worker |
| Location | 2100 S Higgins Ave, Missoula, Montana |
| Authorized Official Name and Position | Emilie Burke (OWNER, CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4065461745 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Pine Psychotherapy Llc 2617 Garland Dr Missoula MT 59803-2009 Ph: (406) 546-1745 | Western Pine Psychotherapy Llc 2100 S Higgins Ave Missoula MT 59801-6761 Ph: (406) 546-1745 |
| NPI Number | 1750844478 |
|---|---|
| Provider Enumeration Date | 04/09/2019 |
| Last Update Date | 04/09/2019 |
| Medicare PECOS PAC ID | 5496126070 |
|---|---|
| Medicare Enrollment ID | O20230118001013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750844478 | NPI | - | NPPES |
| BBH-LCSW-LIC-32067 | Other | MT | STATE OF MONTANA BUSINESS STANDARDS DIVISION BOARD OF BEHAVIORAL HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Emilie Burke |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649754714 PECOS PAC ID: 6305217985 Enrollment ID: I20230118001085 |
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