Provider Demographics
NPI:1215181037
Name:WARNER, STEPHEN HAROLD (LCPC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:HAROLD
Last Name:WARNER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 10TH AVE S STE 4
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2680
Mailing Address - Country:US
Mailing Address - Phone:406-788-1465
Mailing Address - Fax:877-808-2107
Practice Address - Street 1:3511 1ST AVE N STE 1
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-3527
Practice Address - Country:US
Practice Address - Phone:406-403-8531
Practice Address - Fax:866-666-2907
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-06
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC-5227101YP2500X
AZLPC-11387101YP2500X
MT7269101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
COACC-7095OtherCERTIFIED ADDICTIONS COUNSELOR III