MEDICARE: ABREI CLOUD LCSW LLC

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
1	101YM0800X	Mental Health Counselor

Other Identifiers

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

General Provider Information

NPI Number	:	1437712247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABREI CLOUD LCSW LLC

Provider Business Mailing Address
First Line	:	111 N HIGGINS AVE STE 200-5
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-4437
Country	:	US
Telephone Number	:	406-239-1753
Fax Number	:

Provider Business Practice Location Address
First Line	:	111 N HIGGINS AVE STE 200-5
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-4437
Country	:	US
Telephone Number	:	406-239-1753
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST/OWNER
Name	:	MRS. ABREI CLOUD
Credential	:	LCSW
Telephone Number	:	406-239-1753

Provider Enumeration Date	:	04/17/2019
Last Update Date	:	04/24/2019

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