Provider Demographics
NPI:1154491553
Name:EASTON, TAMARA M (LCPC)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:M
Last Name:EASTON
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 20442
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-0442
Mailing Address - Country:US
Mailing Address - Phone:406-690-0603
Mailing Address - Fax:406-294-0967
Practice Address - Street 1:3021 6TH AVE N
Practice Address - Street 2:SUITE 110
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1145
Practice Address - Country:US
Practice Address - Phone:406-690-0603
Practice Address - Fax:406-294-0967
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT891 LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0256594Medicaid
MT000742000OtherBCBS