Provider Demographics
NPI:1508541731
Name:GARRETSON, JEFFREY TODD (MA, PCLC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:TODD
Last Name:GARRETSON
Suffix:
Gender:M
Credentials:MA, PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 2ND ST W
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-3074
Mailing Address - Country:US
Mailing Address - Phone:406-426-3887
Mailing Address - Fax:
Practice Address - Street 1:144 2ND ST W
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-3074
Practice Address - Country:US
Practice Address - Phone:406-426-3887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT63699101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health