Provider Demographics
NPI:1679889240
Name:LAWLER, LARRY J (MSC, LCPC)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:J
Last Name:LAWLER
Suffix:
Gender:M
Credentials:MSC, 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 245
Mailing Address - Street 2:
Mailing Address - City:TREGO
Mailing Address - State:MT
Mailing Address - Zip Code:59934-0245
Mailing Address - Country:US
Mailing Address - Phone:406-291-2827
Mailing Address - Fax:
Practice Address - Street 1:403 1ST. AVE. EAST
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917
Practice Address - Country:US
Practice Address - Phone:406-291-2827
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1502-LCPC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional