# RESTORATIVE MIND THERAPY LLC

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

## Provider details

- **NPI number:** 1871248914
- **Authorized official:** KERI STEPHANOFF LCSW, LCPC, LBA,CMHP (THERAPIST/OWNER)
- **Authorized official phone:** (406) 221-6273

## Contact information

- **Practice address:** 5915 ALBANY AVE, BUTTE, MT 59701-7402
- **Practice address phone:** (406) 221-6273
- **Mailing address:** 116082 FLEECER RD, BUTTE, MT 59750-9710
- **Mailing address phone:** (406) 221-6273

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | — | NULL | — |
| 101YP2500X | Professional Counselor | — | — | — |
| 103K00000X | Behavior Analyst | — | NULL | — |
| 103K00000X | Behavior Analyst | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 02/17/2022
- **Last updated:** 02/21/2022