Provider Demographics
NPI:1841805611
Name:CARLIN, SEAN MICHEL (PCLC)
Entity type:Individual
Prefix:MR
First Name:SEAN
Middle Name:MICHEL
Last Name:CARLIN
Suffix:
Gender:M
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:703 CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-1903
Mailing Address - Country:US
Mailing Address - Phone:406-293-3993
Mailing Address - Fax:406-293-3990
Practice Address - Street 1:703 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-1903
Practice Address - Country:US
Practice Address - Phone:406-293-3993
Practice Address - Fax:406-293-3990
Is Sole Proprietor?:No
Enumeration Date:2020-09-09
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT44148101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health