Provider Demographics
NPI:1093847865
Name:WOMENS COUNSELING CENTER P.C.
Entity Type:Organization
Organization Name:WOMENS COUNSELING CENTER P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GUS
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-864-2808
Mailing Address - Street 1:35510 EDS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ALBERTON
Mailing Address - State:MT
Mailing Address - Zip Code:59820-9441
Mailing Address - Country:US
Mailing Address - Phone:406-728-8388
Mailing Address - Fax:
Practice Address - Street 1:1600 SOUTH AVE W # A
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7804
Practice Address - Country:US
Practice Address - Phone:406-728-8388
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT4731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0503013Medicaid