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Individual

ELLEN VANDEKOP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
825 GREAT NORTHERN BLVD STE 326, HELENA, MT 59601-3392
(406) 850-6595
Mailing address
825 GREAT NORTHERN BLVD STE 326, HELENA, MT 59601-3392
(406) 850-6595

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
BBH-LCPC-LIC-55123
MT
101YP2500X
Professional Counselor
103TP2701X
Group Psychotherapy Psychologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1316691710
MT
01
BBH-LCPC-LIC-55123
LICENSED CLINICAL PROFESSIONAL
MT
Enumeration date
02/05/2022
Last updated
05/18/2022
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