Provider Demographics
NPI:1174001523
Name:PAREDES, CAROLE BREGMAN (LCPC)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:BREGMAN
Last Name:PAREDES
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 1:163 BOWMAN RD # 5
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-9638
Mailing Address - Country:US
Mailing Address - Phone:406-369-3478
Mailing Address - Fax:
Practice Address - Street 1:209 N 10TH ST STE A
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2357
Practice Address - Country:US
Practice Address - Phone:406-532-9101
Practice Address - Fax:406-363-4498
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-29
Last Update Date:2020-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT42588101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional