Organization
RESTORATIVE MIND THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERI STEPHANOFF LCSW, LCPC, LBA,CMHP (THERAPIST/OWNER)
(406) 221-6273
Entity
Organization
Contact information
Practice address
5915 ALBANY AVE, BUTTE, MT 59701-7402
(406) 221-6273
Mailing address
116082 FLEECER RD, BUTTE, MT 59750-9710
(406) 221-6273
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
—
—
103K00000X
Behavior Analyst
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
02/17/2022
Last updated
02/21/2022
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