Provider Demographics
NPI:1184286262
Name:WELCH, CARRIE E (MS, PCLC)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:E
Last Name:WELCH
Suffix:
Gender:F
Credentials:MS, PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 ANNIE GLADE DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7685
Mailing Address - Country:US
Mailing Address - Phone:615-924-1777
Mailing Address - Fax:
Practice Address - Street 1:14 S WILLSON AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6232
Practice Address - Country:US
Practice Address - Phone:406-571-7956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-28
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health