Provider Demographics
NPI:1790206076
Name:LEMONS-VELEZ, SAMI JO
Entity Type:Individual
Prefix:MS
First Name:SAMI
Middle Name:JO
Last Name:LEMONS-VELEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:SAMI
Other - Middle Name:JO
Other - Last Name:DOUGLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 323
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-0323
Mailing Address - Country:US
Mailing Address - Phone:406-926-2011
Mailing Address - Fax:
Practice Address - Street 1:2112 DIXON AVE STE 5
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8226
Practice Address - Country:US
Practice Address - Phone:406-926-2011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-27
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-246261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical