Provider Demographics
NPI:1497078083
Name:ALDRICH, AMY (LPC, LCPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:ALDRICH
Suffix:
Gender:F
Credentials:LPC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 E MAIN ST
Mailing Address - Street 2:SUITE 409
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6241
Mailing Address - Country:US
Mailing Address - Phone:406-522-1555
Mailing Address - Fax:206-260-1444
Practice Address - Street 1:321 E MAIN ST
Practice Address - Street 2:SUITE 409
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6241
Practice Address - Country:US
Practice Address - Phone:406-522-1555
Practice Address - Fax:206-260-1444
Is Sole Proprietor?:No
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3508101YM0800X, 101YP2500X
MT1327-LCPC101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional