Organization
ADOLESCENT & ADULT ADDICTION COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY LEE THOMPSON BSW/LAC (PROVIDER/OWNER)
(406) 863-2050
Entity
Organization
Contact information
Practice address
404 1ST ST, SUITE B, WHITEFISH, MT 59937-2574
(406) 863-2050
(406) 863-2051
Mailing address
404 E 1ST STREET, STE B, WHITEFISH, MT 55937
(406) 863-2050
(406) 863-2051
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1021
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
76050
BLUECROSSBLUESHIELD
MT
Enumeration date
03/13/2008
Last updated
03/13/2008
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