Provider Demographics
NPI:1437814043
Name:MCGRATH, RENEE VAILLANCOURT (LCPC)
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:VAILLANCOURT
Last Name:MCGRATH
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 1:1044 IRON CAP DRIVE
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870
Mailing Address - Country:US
Mailing Address - Phone:406-360-8537
Mailing Address - Fax:406-493-1044
Practice Address - Street 1:1044 IRON CAP DRIVE
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870
Practice Address - Country:US
Practice Address - Phone:406-360-8537
Practice Address - Fax:406-493-1044
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61377190101YM0800X
MTBBH-LCPC-LIC-50721101YM0800X
ORC7072101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health