Provider Demographics
NPI:1558713289
Name:HOUGE, ERIN STACY (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:STACY
Last Name:HOUGE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2606 SOUTH AVE W
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804-6400
Mailing Address - Country:US
Mailing Address - Phone:406-543-0690
Mailing Address - Fax:406-541-4662
Practice Address - Street 1:2606 SOUTH AVE W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-6400
Practice Address - Country:US
Practice Address - Phone:406-541-4663
Practice Address - Fax:406-541-4662
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT185991041C0700X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical