Individual
PAMELA BEATRICE LICCARDI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC/LAC
Contact information
Practice address
1203 US HIGHWAY 2 W, KALISPELL, MT 59901-6071
(406) 314-6565
(406) 314-6566
Mailing address
1701 BLUESTONE DR UNIT B, KALISPELL, MT 59901-7556
(406) 407-8911
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
32924
MT
101YA0400X
Addiction (Substance Use Disorder) Counselor
32949
MT
101YM0800X
Mental Health Counselor
32924
MT
101YP2500X
Professional Counselor
Primary
32924
MT
Other
Enumeration date
10/25/2018
Last updated
10/08/2024
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