Provider Demographics
NPI:1770213787
Name:PIERSON MENTAL HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:PIERSON MENTAL HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:
Authorized Official - Last Name:PIERSON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:907-723-0053
Mailing Address - Street 1:4216 MT HIGHWAY 287
Mailing Address - Street 2:
Mailing Address - City:TWIN BRIDGES
Mailing Address - State:MT
Mailing Address - Zip Code:59754-8732
Mailing Address - Country:US
Mailing Address - Phone:907-723-0053
Mailing Address - Fax:406-684-5923
Practice Address - Street 1:4216 MT HIGHWAY 287
Practice Address - Street 2:
Practice Address - City:TWIN BRIDGES
Practice Address - State:MT
Practice Address - Zip Code:59754-8732
Practice Address - Country:US
Practice Address - Phone:907-723-0053
Practice Address - Fax:406-684-5923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTBBH-LCPC-LIC-38856OtherMT LCPC
MN02561OtherMT LPC