Provider Demographics
NPI:1861449308
Name:GREENBERG, ERIC L (LCPC)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:L
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 SPOKANE AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2600
Mailing Address - Country:US
Mailing Address - Phone:406-890-0004
Mailing Address - Fax:
Practice Address - Street 1:217 2ND ST W
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-3006
Practice Address - Country:US
Practice Address - Phone:406-890-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1133 LCPC101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT752720OtherBLUE CROSS