Provider Demographics
NPI:1215219357
Name:MICU, DEBBIE M (MS, PCLC)
Entity Type:Individual
Prefix:
First Name:DEBBIE
Middle Name:M
Last Name:MICU
Suffix:
Gender:F
Credentials:MS, PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 DEWEY BLVD
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-3214
Mailing Address - Country:US
Mailing Address - Phone:406-498-7060
Mailing Address - Fax:
Practice Address - Street 1:465 S PARK AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-6341
Practice Address - Country:US
Practice Address - Phone:406-498-7060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2021-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT49248101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional