1437314580 NPI number — MRS. RAELYNNE A MCCURDY LCPC, LAC

Table of content: MRS. RAELYNNE A MCCURDY LCPC, LAC (NPI 1437314580)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437314580 NPI number — MRS. RAELYNNE A MCCURDY LCPC, LAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCCURDY
Provider First Name:
RAELYNNE
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCPC, LAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CALBICK
Provider Other First Name:
RAELYNNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCPC, LAC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437314580
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 2ND AVE N
Provider Second Line Business Mailing Address:
STE 650
Provider Business Mailing Address City Name:
GREAT FALLS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-799-5432
Provider Business Mailing Address Fax Number:
406-452-9040

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1601 2ND AVE N
Provider Second Line Business Practice Location Address:
STE 650
Provider Business Practice Location Address City Name:
GREAT FALLS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-799-5432
Provider Business Practice Location Address Fax Number:
406-452-9040
Provider Enumeration Date:
07/28/2008

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: 101YM0800X , with the licence number:  1376-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: 0000744680 . This is a "BLUE CROSS-SHIELD OF MONTANA PROVIDER #" identifier , issued by the state of ( MT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com