Provider Demographics
NPI:1689349334
Name:MAZURKIEWICZ, PATTI JO (LCPC)
Entity Type:Individual
Prefix:
First Name:PATTI
Middle Name:JO
Last Name:MAZURKIEWICZ
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 GOVERNORS BLVD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-2202
Mailing Address - Country:US
Mailing Address - Phone:406-366-9708
Mailing Address - Fax:
Practice Address - Street 1:1140 GOVERNORS BLVD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-2202
Practice Address - Country:US
Practice Address - Phone:406-663-4315
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-14
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT42554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health