# GLACIER TRAILS COUNSELING LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265260285
- **Authorized official:** TERRAN EASTHAM (MENTAL HEALTH THERAPIST)
- **Authorized official phone:** (406) 414-9623

## Contact information

- **Practice address:** 2601 S 3RD ST W, MISSOULA, MT 59804-1143
- **Practice address phone:** (406) 414-9623
- **Mailing address:** PO BOX 16331, MISSOULA, MT 59808-6331
- **Mailing address phone:** (406) 414-9623

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 07/22/2024
- **Last updated:** 09/13/2024