Provider Demographics
NPI:1558447862
Name:STENBERG, MONA (RN, LCPC)
Entity Type:Individual
Prefix:
First Name:MONA
Middle Name:
Last Name:STENBERG
Suffix:
Gender:F
Credentials:RN, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6093
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59771-6093
Mailing Address - Country:US
Mailing Address - Phone:406-570-9992
Mailing Address - Fax:
Practice Address - Street 1:109 S 8TH AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4460
Practice Address - Country:US
Practice Address - Phone:406-570-9992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT913LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT745013OtherBCBS NUMBER