Provider Demographics
NPI:1942646492
Name:PINNOW, MICHELLE MARIE (MS,LCPC, LAC)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:PINNOW
Suffix:
Gender:F
Credentials:MS,LCPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 GRAND AVE STE 141
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2763
Mailing Address - Country:US
Mailing Address - Phone:406-213-9640
Mailing Address - Fax:406-794-0073
Practice Address - Street 1:1925 GRAND AVE STE 141
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102
Practice Address - Country:US
Practice Address - Phone:406-213-9640
Practice Address - Fax:406-794-0073
Is Sole Proprietor?:No
Enumeration Date:2013-05-10
Last Update Date:2019-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLAC-LAC-LIC-1364101YA0400X
MTBBH-LCPC-LIC-30458101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)