Provider Demographics
NPI:1265202550
Name:MENA, HUNTER D (SWLC)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:D
Last Name:MENA
Suffix:
Gender:M
Credentials:SWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1260 MORNING EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-9185
Mailing Address - Country:US
Mailing Address - Phone:406-491-1603
Mailing Address - Fax:
Practice Address - Street 1:165 COMMONS LOOP STE B
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1919
Practice Address - Country:US
Practice Address - Phone:406-491-1603
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-628411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical