# AUTHENTIC FOUNDATIONS LLC

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

## Provider details

- **NPI number:** 1396610424
- **Authorized official:** JAMA MAULDIN LCSW (OWNER/ THERAPIST)
- **Authorized official phone:** (406) 239-4647

## Contact information

- **Practice address:** 2315 MCDONALD AVE STE 101, MISSOULA, MT 59801-7343
- **Practice address phone:** (406) 239-4647
- **Mailing address:** 2315 MCDONALD AVE STE 101, MISSOULA, MT 59801-7343
- **Mailing address phone:** (406) 239-4647

## Taxonomy

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

## Other

- **Enumeration date:** 10/08/2025
- **Last updated:** 10/08/2025