Individual
ELLEN MITTLESTADT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2001 S RUSSELL ST, MISSOULA, MT 59801-6621
(406) 493-0143
Mailing address
PO BOX 5102, MISSOULA, MT 59806-5102
(406) 493-0143
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-ACLC-LIC-81472
MT
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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