Provider Demographics
NPI:1639364268
Name:FLYNN, PATRICIA M (LAC)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:M
Last Name:FLYNN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2334 LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3927
Mailing Address - Country:US
Mailing Address - Phone:406-245-6539
Mailing Address - Fax:406-245-9647
Practice Address - Street 1:2334 LEWIS AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3927
Practice Address - Country:US
Practice Address - Phone:406-245-6539
Practice Address - Fax:406-245-9647
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1172101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)