Provider Demographics
NPI:1336545458
Name:SHUTEY, MAGGIE (LCPC)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:SHUTEY
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 W PARK ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1713
Mailing Address - Country:US
Mailing Address - Phone:406-723-1694
Mailing Address - Fax:406-723-1690
Practice Address - Street 1:2600 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-5025
Practice Address - Country:US
Practice Address - Phone:406-533-2636
Practice Address - Fax:406-533-2600
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-17
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8770101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health