Provider Demographics
NPI:1790558161
Name:HASENYAGER, NAOMI DEE (LCPC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:DEE
Last Name:HASENYAGER
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:PO BOX 1985
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-1985
Mailing Address - Country:US
Mailing Address - Phone:406-272-6099
Mailing Address - Fax:
Practice Address - Street 1:2315 MCDONALD AVE STE 101
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7343
Practice Address - Country:US
Practice Address - Phone:406-272-6099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-06
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT50691101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health