Healthcare Provider Details

I. General information

NPI: 1942857933
Provider Name (Legal Business Name): EMMAUS COUNSELING SERVICES OF MONTANA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2019
Last Update Date: 09/11/2024
Certification Date: 09/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 N LAST CHANCE GULCH STE 306
HELENA MT
59601-5012
US

IV. Provider business mailing address

820 N FEE ST
HELENA MT
59601-3153
US

V. Phone/Fax

Practice location:
  • Phone: 307-331-2661
  • Fax:
Mailing address:
  • Phone: 307-331-2661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: BILL ANAGNOS
Title or Position: MANAGER
Credential:
Phone: 309-808-0662