Provider Demographics
NPI:1407978117
Name:WOSNICK, SHARON (PHD, LCPC, LAC)
Entity Type:Individual
Prefix:DR
First Name:SHARON
Middle Name:
Last Name:WOSNICK
Suffix:
Gender:F
Credentials:PHD, LCPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2732 TREASURE DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1145
Mailing Address - Country:US
Mailing Address - Phone:406-655-4326
Mailing Address - Fax:
Practice Address - Street 1:3300 2ND AVE N
Practice Address - Street 2:SUITE 8
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-2011
Practice Address - Country:US
Practice Address - Phone:406-252-1414
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT924101YA0400X
MT839101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0252994Medicaid