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Individual
LANCE E ELLER
Active
Individual
LANCE E ELLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC, LCPC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
743
MT
101YM0800X
Mental Health Counselor
Primary
1274
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
760600
BLUE CROSS/BLUE SHIELD
MT
Enumeration date
10/05/2005
Last updated
02/22/2017
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