NPI 1699772079 · live from the CMS NPI Registry
Lisa Rae Anderson Mangan, LCPC
Counselor, Professional in Great Falls, MT. National Provider Identifier 1699772079, active.
NPI record
| NPI | 1699772079 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Counselor, Professional 101YP2500X |
| Practice location | 120 23rd Ave Ne, Great Falls, MT 59404 |
| Practice phone | 406-453-6784 |
| Enumerated | June 30, 2005 |
| Last updated | April 1, 2008 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Professional primary | 101YP2500X | LCPC 762 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.