Provider Demographics
NPI:1225347669
Name:CAPITAL CITY CONSULTANTS PC
Entity Type:Organization
Organization Name:CAPITAL CITY CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:BOWMAN
Authorized Official - Last Name:SMELKO
Authorized Official - Suffix:JR
Authorized Official - Credentials:PSYD
Authorized Official - Phone:406-461-1744
Mailing Address - Street 1:4745 WAGNER PL
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-9674
Mailing Address - Country:US
Mailing Address - Phone:406-442-6115
Mailing Address - Fax:
Practice Address - Street 1:4745 WAGNER PL
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-9674
Practice Address - Country:US
Practice Address - Phone:406-442-6115
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-04
Last Update Date:2010-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT394103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty