Provider Demographics
NPI:1114482619
Name:LABARGE, VANESSA JUDITH (LCPC, NCC)
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:JUDITH
Last Name:LABARGE
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CENTRAL AVE
Mailing Address - Street 2:SUITE 601
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3128
Mailing Address - Country:US
Mailing Address - Phone:406-590-6364
Mailing Address - Fax:
Practice Address - Street 1:410 CENTRAL AVE
Practice Address - Street 2:SUITE 601
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3128
Practice Address - Country:US
Practice Address - Phone:406-590-6364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-08
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT39037101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional