Provider Demographics
NPI:1710128764
Name:MURI, DENNIS W (LCSW, LAC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:W
Last Name:MURI
Suffix:
Gender:M
Credentials:LCSW, LAC
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 21292
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-1292
Mailing Address - Country:US
Mailing Address - Phone:406-696-2246
Mailing Address - Fax:
Practice Address - Street 1:1645 PARKHILL DR STE 1
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3067
Practice Address - Country:US
Practice Address - Phone:406-696-2246
Practice Address - Fax:406-794-0206
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-19
Last Update Date:2022-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1130101YA0400X
MT841-LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)