Provider Demographics
NPI:1437712247
Name:ABREI CLOUD LCSW LLC
Entity Type:Organization
Organization Name:ABREI CLOUD LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ABREI
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOUD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-239-1753
Mailing Address - Street 1:111 N HIGGINS AVE STE 200-5
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4437
Mailing Address - Country:US
Mailing Address - Phone:406-239-1753
Mailing Address - Fax:
Practice Address - Street 1:111 N HIGGINS AVE STE 200-5
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4437
Practice Address - Country:US
Practice Address - Phone:406-239-1753
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-17
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1679952873Medicaid