Provider Demographics
NPI:1164121745
Name:MARK DADMUN COUNSELING, PLLC
Entity Type:Organization
Organization Name:MARK DADMUN COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:DADMUN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-333-6975
Mailing Address - Street 1:400 W. BROADWAY ST
Mailing Address - Street 2:SUITE 101 - BOX 329
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4136
Mailing Address - Country:US
Mailing Address - Phone:406-333-6975
Mailing Address - Fax:
Practice Address - Street 1:210 N HIGGINS AVE STE 227
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4497
Practice Address - Country:US
Practice Address - Phone:406-333-6975
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-02
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty