Provider Demographics
NPI:1851651863
Name:MOUSER, TERESA MARIE (LCPC)
Entity Type:Individual
Prefix:
First Name:TERESA
Middle Name:MARIE
Last Name:MOUSER
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 1:1601 2ND AVE N STE 208
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3286
Mailing Address - Country:US
Mailing Address - Phone:406-590-1550
Mailing Address - Fax:888-279-4130
Practice Address - Street 1:1601 2ND AVE N STE 208
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401
Practice Address - Country:US
Practice Address - Phone:406-590-1550
Practice Address - Fax:888-279-4130
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1379101YA0400X
MT22680101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)