Provider Demographics
NPI:1508259581
Name:WELBORN, MARNETA (LCPC)
Entity Type:Individual
Prefix:
First Name:MARNETA
Middle Name:
Last Name:WELBORN
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 1:926 MAIN ST STE 14
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3359
Mailing Address - Country:US
Mailing Address - Phone:406-702-2436
Mailing Address - Fax:
Practice Address - Street 1:926 MAIN ST STE 14
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3359
Practice Address - Country:US
Practice Address - Phone:406-702-2436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-14
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY101Y00000X
WYCAP143101YA0400X
MT39017101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)