# MY HEALTHY LIFE COUNSELING LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1376183525
- **Authorized official:** LOWELL OWEN WAVRICK LAC (OWNER/EMPLOYEE)
- **Authorized official phone:** (406) 945-1730

## Contact information

- **Practice address:** 738 KENSINGTON AVE, MISSOULA, MT 59801-5720
- **Practice address phone:** (406) 945-1730
- **Mailing address:** 4998 SONOMA ST, MISSOULA, MT 59808-8694
- **Mailing address phone:** (406) 945-1730

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | NULL | Yes |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | — | — | Yes |

## Other

- **Enumeration date:** 01/15/2020
- **Last updated:** 12/29/2020