Organization
LIVING WELL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE MILDENBERGER LCSW (OWNER/THERAPIST)
(406) 363-2873
Entity
Organization
Contact information
Practice address
400 W MAIN ST STE 203, HAMILTON, MT 59840-2443
(406) 363-2873
Mailing address
PO BOX 1707, HAMILTON, MT 59840-1707
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
7731-C
NV
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-12274
MT
Other
Enumeration date
01/02/2018
Last updated
03/28/2018
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