| Willow Canyon Counseling Services | |
|
302 1st St W Ste 203 Polson MT 59860-2602 | |
| (406) 270-3447 | |
| Not Available |
| Full Name | Willow Canyon Counseling Services |
|---|---|
| Speciality | Clinic/Center |
| Location | 302 1st St W Ste 203, Polson, Montana |
| Authorized Official Name and Position | Shaunda Marie Albert (OWNER) |
| Authorized Official Contact | 4062605085 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Canyon Counseling Services 42522 Canal Rd Ronan MT 59864-9002 Ph: (406) 260-5085 | Willow Canyon Counseling Services 302 1st St W Ste 203 Polson MT 59860-2602 Ph: (406) 270-3447 |
| NPI Number | 1023525771 |
|---|---|
| Provider Enumeration Date | 01/03/2018 |
| Last Update Date | 02/04/2022 |
| Certification Date | 02/02/2022 |
| Medicare PECOS PAC ID | 3476944430 |
|---|---|
| Medicare Enrollment ID | O20211229001969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023525771 | NPI | - | NPPES |
| Provider Name | Shaunda Marie Albert |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912407198 PECOS PAC ID: 4385035344 Enrollment ID: I20220208000201 |
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