MEDICARE: CLARK CITY COUNSELING

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	101YA0400X	Addiction (Substance Use Disorder) Counselor
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1487356424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLARK CITY COUNSELING

Provider Business Mailing Address
First Line	:	117 S 10TH ST
Second Line	:
City	:	LIVINGSTON
State	:	MT
Zip	:	59047-2519
Country	:	US
Telephone Number	:	406-220-6204
Fax Number	:

Provider Business Practice Location Address
First Line	:	119 1/2 W PARK ST STE 5
Second Line	:
City	:	LIVINGSTON
State	:	MT
Zip	:	59047-2661
Country	:	US
Telephone Number	:	406-220-6204
Fax Number	:

Authorized Official
Title or Position	:	OWNER PROPRIETOR
Name	:	MS. JULIE ANDERSON
Credential	:	LCSW, LAC
Telephone Number	:	406-220-6204

Provider Enumeration Date	:	03/21/2023
Last Update Date	:	02/11/2026

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Directions to “CLARK CITY COUNSELING ” Practice Location

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