Individual
MR. BRENDEN EUGENE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPCC, LCPC
Contact information
Practice address
2875 TINA AVE STE 106, MISSOULA, MT 59808-1582
(406) 552-3587
Mailing address
6315 LONE MOOSE CT, FLORENCE, MT 59833-6005
(505) 977-5376
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0013284
CO
101YP2500X
Professional Counselor
Primary
0181451
NM
101YP2500X
Professional Counselor
BBH-LCPC-LIC-43089
MT
101YP2500X
Professional Counselor
T-0164301
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0686766
—
MT
05
—
1780008342
—
NM
Enumeration date
02/18/2014
Last updated
07/19/2022
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