Provider Demographics
NPI:1306396924
Name:MEGAN BAKER WELLES INTEGRATIVE COUNSELING, LLC
Entity Type:Organization
Organization Name:MEGAN BAKER WELLES INTEGRATIVE COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:K
Authorized Official - Last Name:BAKER WELLES
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, LMFT
Authorized Official - Phone:406-407-0935
Mailing Address - Street 1:145 NORTHRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2634
Mailing Address - Country:US
Mailing Address - Phone:406-407-0935
Mailing Address - Fax:
Practice Address - Street 1:145 NORTHRIDGE DR
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-2634
Practice Address - Country:US
Practice Address - Phone:406-407-0935
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT19005101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty