Organization
OXYTOCIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA LICCARDI LCPC/LAC (OWNER/MANAGER)
(406) 407-8911
Entity
Organization
Contact information
Practice address
1203 US HIGHWAY 2 W STE 15, KALISPELL, MT 59901-3465
(406) 314-6565
(406) 314-3566
Mailing address
1203 US HIGHWAY 2 W STE 15, KALISPELL, MT 59901-3465
(406) 314-6565
(406) 314-6566
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
12/04/2018
Last updated
11/12/2024
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