Provider Demographics
NPI:1821301151
Name:LAY, MARCETTA M (LAC)
Entity Type:Individual
Prefix:
First Name:MARCETTA
Middle Name:M
Last Name:LAY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:553 TOOLE CT
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-6947
Mailing Address - Country:US
Mailing Address - Phone:406-458-9839
Mailing Address - Fax:
Practice Address - Street 1:435 N LAST CHANCE GULCH
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5015
Practice Address - Country:US
Practice Address - Phone:406-449-5796
Practice Address - Fax:406-449-5797
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT620101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)