Provider Demographics
NPI:1912243890
Name:LAMARR, STEPHANIE (RN MSN-PH, LCPC, LAC)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:LAMARR
Suffix:
Gender:F
Credentials:RN MSN-PH, LCPC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:972 FLANDERS CREEK AVE
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6363
Mailing Address - Country:US
Mailing Address - Phone:406-551-0276
Mailing Address - Fax:406-551-0276
Practice Address - Street 1:972 FLANDERS CREEK AVE
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6363
Practice Address - Country:US
Practice Address - Phone:406-732-2603
Practice Address - Fax:406-213-1669
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-62683101YA0400X
MTBBH-PCLC-LIC-57326101YM0800X
MTNUR-RN-LIC-72572163WP0809X
MTBBH-LCPC-LIC-64370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult