Provider Demographics
NPI:1700334489
Name:NOLAND-SEPKO, ELAINE (LCPC)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:NOLAND-SEPKO
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 1:1409 GRANITE CT
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-7082
Mailing Address - Country:US
Mailing Address - Phone:406-240-1877
Mailing Address - Fax:
Practice Address - Street 1:1409 GRANITE CT
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-7082
Practice Address - Country:US
Practice Address - Phone:406-240-1877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-12
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61311643101YM0800X
MI6401223000101YP2500X
WYLPC-2136101YP2500X
MTBBH-LCPC-LIC-19130101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health