Individual
SHAUNDA MARIE ALBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, MAC, LCSW
Contact information
Practice address
302 1ST ST W STE 203, POLSON, MT 59860-2602
(406) 270-3447
Mailing address
42522 CANAL RD, RONAN, MT 59864-9002
(406) 270-3447
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
BBH-LAC-LIC-1275
MT
1041C0700X
Clinical Social Worker
50202
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1023525771
—
MT
01
—
13803682
CAQH
—
01
—
BBH-LAC-LIC-1275
LAC LICENSE
MT
Enumeration date
02/14/2018
Last updated
09/16/2021
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