MEDICARE: ELISE MAGGIO 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

General Provider Information

NPI Number	:	1770382582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ELISE MAGGIO LLC

Provider Business Mailing Address
First Line	:	420 N PACIFIC ST
Second Line	:
City	:	DILLON
State	:	MT
Zip	:	59725-2934
Country	:	US
Telephone Number	:	512-410-9848
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 N MONTANA ST
Second Line	:
City	:	DILLON
State	:	MT
Zip	:	59725-3300
Country	:	US
Telephone Number	:	512-410-9848
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ELISE MAGGIO
Credential	:	LCPC
Telephone Number	:	512-410-9848

Provider Enumeration Date	:	03/12/2025
Last Update Date	:	03/12/2025

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Directions to “ELISE MAGGIO LLC ” Practice Location

Language	Start Address	Practice Location

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