Individual
STEWART ANDREW MCCRACKEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
491 SHAW GULCH LN, SUPERIOR, MT 59872-0124
(406) 304-6371
(866) 261-3089
Mailing address
PO BOX 124, SUPERIOR, MT 59872-0124
(406) 304-6371
(866) 261-3089
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1951
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265066500
—
MT
Enumeration date
05/23/2012
Last updated
07/29/2020
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