Healthcare Provider Details

I. General information

NPI: 1942238001
Provider Name (Legal Business Name): LAURA BETH BLOCK M.ED., LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA BLOCK LOWER LCPC

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 03/22/2024
Certification Date: 03/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 W BROADWAY ST
BUTTE MT
59701-9104
US

IV. Provider business mailing address

531 W BROADWAY ST
BUTTE MT
59701-9104
US

V. Phone/Fax

Practice location:
  • Phone: 406-580-4685
  • Fax:
Mailing address:
  • Phone: 406-580-4685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number1129
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberBBH-LCPC-LIC-1129
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: