Provider Demographics
NPI:1710028402
Name:ULRICH, MICHAEL (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:ULRICH
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:848 MAIN ST 21
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3361
Mailing Address - Country:US
Mailing Address - Phone:406-698-3128
Mailing Address - Fax:
Practice Address - Street 1:848 MAIN ST
Practice Address - Street 2:SUITE 21
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-3358
Practice Address - Country:US
Practice Address - Phone:406-698-3128
Practice Address - Fax:406-245-1156
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT70038OtherBCBS LEGACY NUMBER