Provider Demographics
NPI:1356767032
Name:VICARS, AMY (LCPC, LAC, MAC, CRC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:VICARS
Suffix:
Gender:F
Credentials:LCPC, LAC, MAC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22792
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-2792
Mailing Address - Country:US
Mailing Address - Phone:406-855-9221
Mailing Address - Fax:
Practice Address - Street 1:2475 VILLAGE LN STE 102
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2497
Practice Address - Country:US
Practice Address - Phone:406-855-9221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLAC-LAC-LIC-3327101YA0400X
MTBBH-LCPC-LIC-23768101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health