Healthcare Provider Details

I. General information

NPI: 1225068869
Provider Name (Legal Business Name): STEPHEN WHITNEY JR. MPC, LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 W GRANITE ST
BUTTE MT
59701-9215
US

IV. Provider business mailing address

125 W GRANITE ST
BUTTE MT
59701-9215
US

V. Phone/Fax

Practice location:
  • Phone: 406-723-0190
  • Fax: 406-563-5794
Mailing address:
  • Phone: 406-723-0190
  • Fax: 406-563-5794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number391
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: