Healthcare Provider Details

I. General information

NPI: 1679769301
Provider Name (Legal Business Name): SHELLEY WINDSOR M.A. LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2007
Last Update Date: 05/03/2022
Certification Date: 05/03/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 W 5TH ST
ANACONDA MT
59711-2026
US

IV. Provider business mailing address

PO BOX 566
ANACONDA MT
59711-0566
US

V. Phone/Fax

Practice location:
  • Phone: 406-490-8300
  • Fax:
Mailing address:
  • Phone: 406-490-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number44032
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number1035
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: