Provider Demographics
NPI:1639671191
Name:FULL SPECTRUM PSYCHOTHERAPY INC
Entity Type:Organization
Organization Name:FULL SPECTRUM PSYCHOTHERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-827-9330
Mailing Address - Street 1:PO BOX 1906
Mailing Address - Street 2:
Mailing Address - City:THOMPSON FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59873-1906
Mailing Address - Country:US
Mailing Address - Phone:406-827-9330
Mailing Address - Fax:
Practice Address - Street 1:1119 MAIDEN LANE
Practice Address - Street 2:
Practice Address - City:THOMPSON FALLS
Practice Address - State:MT
Practice Address - Zip Code:59873
Practice Address - Country:US
Practice Address - Phone:406-827-9330
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-01
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty