Provider Demographics
NPI:1952096471
Name:WINSOME THERAPY CLINIC LLC
Entity type:Organization
Organization Name:WINSOME THERAPY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BEHAVIOR ANALYST
Authorized Official - Prefix:
Authorized Official - First Name:LIDIANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:KERR
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:406-860-1480
Mailing Address - Street 1:1215 24TH ST W STE 130
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-3895
Mailing Address - Country:US
Mailing Address - Phone:406-901-5000
Mailing Address - Fax:406-552-1482
Practice Address - Street 1:1215 24TH ST W STE 130
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-3895
Practice Address - Country:US
Practice Address - Phone:406-901-5000
Practice Address - Fax:406-552-1482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-10
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty