Healthcare Provider Details

I. General information

NPI: 1639314842
Provider Name (Legal Business Name): GRACE L ZACAROLI LCHMC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 10/12/2021
Certification Date: 10/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 S 27TH ST
BILLINGS MT
59101-4200
US

IV. Provider business mailing address

1465 HOOKSETT RD UNIT 1371
HOOKSETT NH
03106-1892
US

V. Phone/Fax

Practice location:
  • Phone: 406-247-3350
  • Fax:
Mailing address:
  • Phone: 603-315-2862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1368
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number860
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: