# PROVIDENCE HEALTH & SERVICES MT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROVIDENCE HEALTH & SERVICES MT
- **Other names:** PMT MT Urgent Mental Health, PROVIDENCE MEDICAL GROUP MONTANA, PMG MT PSYCHIATRY AND COUNSELING
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1558530683
- **Legal business name:** PROVIDENCE HEALTH & SERVICES MT
- **Authorized official:** DONALD W ANDERSON JR. (ASSISTANT SECRETARY ENROLLMENT)
- **Authorized official phone:** (425) 358-9786

## Contact information

- **Practice address:** 900 N ORANGE ST STE 202, MISSOULA, MT 59802-2951
- **Practice address phone:** (406) 327-3029
- **Mailing address:** PO BOX 31001 - 4114, PASADENA, CA 91110-4114

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 17652 | MT | Yes |

## Other

- **Enumeration date:** 02/22/2008
- **Last updated:** 09/17/2026