Healthcare Provider Details

I. General information

NPI: 1174931570
Provider Name (Legal Business Name): SHAWNA L. GUAY MS, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 07/29/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 W PARK ST
BUTTE MT
59701-1713
US

IV. Provider business mailing address

81 W PARK ST
BUTTE MT
59701-1713
US

V. Phone/Fax

Practice location:
  • Phone: 406-497-9000
  • Fax:
Mailing address:
  • Phone: 406-497-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberSWP-LCPC-LIC-8329
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: