1487769592 NPI number — MARY MARGARET GARMAN LCPC

Table of content: MARY MARGARET GARMAN LCPC (NPI 1487769592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487769592 NPI number — MARY MARGARET GARMAN LCPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GARMAN
Provider First Name:
MARY
Provider Middle Name:
MARGARET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GARMAN
Provider Other First Name:
MARY
Provider Other Middle Name:
WOOD
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCPC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1487769592
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1271
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TOWNSEND
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59644-1271
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-266-4867
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
417 BROADWAY ST
Provider Second Line Business Practice Location Address:
CENTER FOR MENTAL HEALTH
Provider Business Practice Location Address City Name:
TOWNSEND
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59644-2323
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-266-3327
Provider Business Practice Location Address Fax Number:
406-266-4840
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  856 LCPC , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0000741590 . This is a "BLUE CROSS/SHIELD OF MONT" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




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