Doctor Name: | JEANIE WINSTROM |
NPI Number: | 1063809325 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA LCPC |
License Number: | SWP-LCPC-LIC-11900 |
Business Practice Address: | 55 Basin Creek Rd Butte, MT - 597019704 |
Business Phone Number: | 4064966314 |
Business Fax Number: | 4064941724 |
Mailing Address: | 150 Education Way, LIBBY |
State: | MT |
Postal Code: | 599232816 |
Phone Number: | 4062938802 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2015 |
NPI Last Update Date: | 04/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | SWP-LCPC-LIC-11900 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |