Individual
MR. WALTER JAMES SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MA, LCPC, NCC
Contact information
Practice address
4 HARNISH LANE, RED LODGE, MT 59068-1992
(406) 671-6289
(406) 446-2114
Mailing address
PO BOX 1992, RED LODGE, MT 59068-1992
(406) 672-6289
(406) 446-2114
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCPC 40
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0252297
—
MT
01
—
07547-0
MT BLUECROSS BLUESHIELD
MT
Enumeration date
03/30/2007
Last updated
07/09/2007
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