Provider Demographics
NPI:1780115105
Name:TROTTMAN, MELANIE LYNN (LAC)
Entity type:Individual
Prefix:MS
First Name:MELANIE
Middle Name:LYNN
Last Name:TROTTMAN
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:LYNN
Other - Last Name:JENNINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:3240 DREDGE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0548
Mailing Address - Country:US
Mailing Address - Phone:406-442-7920
Mailing Address - Fax:
Practice Address - Street 1:4409 2ND AVE N APT 5
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-1402
Practice Address - Country:US
Practice Address - Phone:406-561-0695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP00004773101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)