Provider Demographics
NPI:1558869123
Name:NESTING COMMUNITIES COUNSELING AND ART THERAPY PLLC
Entity Type:Organization
Organization Name:NESTING COMMUNITIES COUNSELING AND ART THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JULIENNE
Authorized Official - Middle Name:N
Authorized Official - Last Name:REID STICKNEY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:913-302-7725
Mailing Address - Street 1:909 BYRON ST UNIT 203
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-2273
Mailing Address - Country:US
Mailing Address - Phone:913-302-7725
Mailing Address - Fax:
Practice Address - Street 1:334 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4618
Practice Address - Country:US
Practice Address - Phone:913-302-7725
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT22757101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty