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NPI Code Detail

MEDICARE: CONNIE DILTS LCPC, LMFT

MEDICARE: CONNIE DILTS LCPC, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor489LCPCMT
2106H00000XMarriage & Family Therapist126MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000074965OTHERMTBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285646133
Entity Type Code : Individual
Provider Name (Legal Business Name) : CONNIE DILTS LCPC, LMFT
Provider Business Mailing Address
First Line : 902 WYOMING AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59101-1637
Country : US
Telephone Number : 406-254-8604
Fax Number : 406-294-0967
Provider Business Practice Location Address
First Line : 902 WYOMING AVE
Second Line :
City : BILLINGS
State : MT
Zip : 59101-1637
Country : US
Telephone Number : 406-254-8604
Fax Number : 406-294-0967
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2006
Last Update Date : 12/12/2011

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