Provider Demographics
NPI:1275090466
Name:MOUNTAIN VIEW COUNSELING LLC
Entity Type:Organization
Organization Name:MOUNTAIN VIEW COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARTHY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:307-413-5803
Mailing Address - Street 1:633 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:ID
Mailing Address - Zip Code:83254-1448
Mailing Address - Country:US
Mailing Address - Phone:307-413-5803
Mailing Address - Fax:208-417-1157
Practice Address - Street 1:422 S WASHINGTON ST
Practice Address - Street 2:STE 3
Practice Address - City:AFTON
Practice Address - State:WY
Practice Address - Zip Code:83110
Practice Address - Country:US
Practice Address - Phone:907-545-6645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-25
Last Update Date:2019-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty