Individual
MELISSA EASTLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3031 S RUSSELL ST STE B, MISSOULA, MT 59801-8523
(406) 207-1181
Mailing address
2173 AMITY LN, MISSOULA, MT 59804-5109
(406) 207-1181
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
88657
MT
1041C0700X
Clinical Social Worker
Primary
BBH-SWLC-LIC56869
MT
Other
Enumeration date
01/01/2025
Last updated
07/06/2026
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