Provider Demographics
NPI:1851095384
Name:ROTTENBILLER, ANNIE MARIA (LCSW, ACLC)
Entity Type:Individual
Prefix:
First Name:ANNIE
Middle Name:MARIA
Last Name:ROTTENBILLER
Suffix:
Gender:F
Credentials:LCSW, ACLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-2703
Mailing Address - Country:US
Mailing Address - Phone:406-212-2724
Mailing Address - Fax:
Practice Address - Street 1:501 N PARK AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-2703
Practice Address - Country:US
Practice Address - Phone:406-212-2724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-ACLC-LIC-55179101YA0400X
MTBBH-LCSW-LIC-622941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)