Provider Demographics
NPI:1336506807
Name:STANWOOD, CHRISTL (LCPC)
Entity Type:Individual
Prefix:
First Name:CHRISTL
Middle Name:
Last Name:STANWOOD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 COUGAR TRL
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-8431
Mailing Address - Country:US
Mailing Address - Phone:406-261-6256
Mailing Address - Fax:
Practice Address - Street 1:200 HERITAGE WAY
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3146
Practice Address - Country:US
Practice Address - Phone:406-752-5111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-28
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT15794101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional