Provider Demographics
NPI:1689091365
Name:DANDLIKER, AMY (LCPC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:DANDLIKER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:PERKIC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2814 BROOKS ST # 153
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-7718
Mailing Address - Country:US
Mailing Address - Phone:406-698-1954
Mailing Address - Fax:
Practice Address - Street 1:1721 HUMBLE RD
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59804-5089
Practice Address - Country:US
Practice Address - Phone:406-698-1954
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-19
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7778101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional