Provider Demographics
NPI:1669963732
Name:CLEARMAN, THERESA (LCPC)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:CLEARMAN
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 1:414 N BENTON AVE STE F
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5040
Mailing Address - Country:US
Mailing Address - Phone:406-422-9448
Mailing Address - Fax:
Practice Address - Street 1:414 N BENTON AVE STE F
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5040
Practice Address - Country:US
Practice Address - Phone:406-422-9448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-30456101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional