Provider Demographics
NPI:1043414725
Name:STRZELCZYK, JENNIFER ELIZABETH (LCPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:STRZELCZYK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1254
Mailing Address - Street 2:606 S 4TH ST E
Mailing Address - City:MALTA
Mailing Address - State:MT
Mailing Address - Zip Code:59538-1254
Mailing Address - Country:US
Mailing Address - Phone:406-654-2345
Mailing Address - Fax:406-654-2002
Practice Address - Street 1:606 S 4TH ST E
Practice Address - Street 2:
Practice Address - City:MALTA
Practice Address - State:MT
Practice Address - Zip Code:59538-1254
Practice Address - Country:US
Practice Address - Phone:406-654-2345
Practice Address - Fax:406-654-2002
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1292101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1292OtherLISCENSE NUMBER