Healthcare Provider Details

I. General information

NPI: 1174001523
Provider Name (Legal Business Name): CAROLE BREGMAN PAREDES LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2018
Last Update Date: 02/04/2020
Certification Date: 02/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 N 10TH ST STE A
HAMILTON MT
59840-2357
US

IV. Provider business mailing address

163 BOWMAN RD # 5
HAMILTON MT
59840-9638
US

V. Phone/Fax

Practice location:
  • Phone: 406-532-9101
  • Fax: 406-363-4498
Mailing address:
  • Phone: 406-369-3478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number42588
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: