Individual
MICHAEL EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.A., LCPC, LAC
Contact information
Practice address
2004 HOSPITAL WAY, WHITEFISH, MT 59937-7858
(406) 862-1030
Mailing address
2004 HOSPITAL WAY, WHITEFISH, MT 59937-7858
(406) 862-1030
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
650
NH
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-13219
MT
101YM0800X
Mental Health Counselor
Primary
736
NH
101YM0800X
Mental Health Counselor
BBH-LCPC-LIC-13148
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77066380NH01
ANTHEM
—
Enumeration date
04/03/2007
Last updated
02/05/2016
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