Provider Demographics
NPI:1184426579
Name:WELCH, MICHELLE LYNN
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:LYNN
Last Name:WELCH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 CAMERON ROSE LN
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-6269
Mailing Address - Country:US
Mailing Address - Phone:406-303-0888
Mailing Address - Fax:
Practice Address - Street 1:5527 OLD US HWY 93
Practice Address - Street 2:SUITE B
Practice Address - City:FLORENCE
Practice Address - State:MT
Practice Address - Zip Code:59833
Practice Address - Country:US
Practice Address - Phone:406-303-0888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-26
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBHLCSWLIC74968101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health