MEDICARE: TROOP WELFARE COUNSELING AND FAMILY SERVICES, 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	101Y00000X	Counselor	101Y00000X	MT
2	101YM0800X	Mental Health Counselor	101YM0800X	MT
3	106H00000X	Marriage & Family Therapist	106H00000X	MT
4	104100000X	Social Worker	104100000X	MT

General Provider Information

NPI Number	:	1649685439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TROOP WELFARE COUNSELING AND FAMILY SERVICES, LLC

Provider Business Mailing Address
First Line	:	600 CENTRAL AVE STE 305
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3157
Country	:	US
Telephone Number	:	760-310-8233
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 CENTRAL AVE STE 305
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59401-3157
Country	:	US
Telephone Number	:	760-310-8233
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	JOSEPH MILLER
Credential	:
Telephone Number	:	760-310-8233

Provider Enumeration Date	:	06/30/2014
Last Update Date	:	06/30/2014

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