Healthcare Provider Details

I. General information

NPI: 1205800281
Provider Name (Legal Business Name): ELIZABETH JEAN BRONEC LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 N LAST CHANCE GULCH ST SUITE 2A
HELENA MT
59601-4125
US

IV. Provider business mailing address

800 BRECKENRIDGE ST
HELENA MT
59601-4432
US

V. Phone/Fax

Practice location:
  • Phone: 406-443-1990
  • Fax: 406-443-1391
Mailing address:
  • Phone: 406-443-5377
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1200 LCPC
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: