Healthcare Provider Details

I. General information

NPI: 1508779331
Provider Name (Legal Business Name): ELEANOR WOODFIN CRAIG PCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 1ST AVE E
KALISPELL MT
59901-4935
US

IV. Provider business mailing address

PO BOX 885
KILA MT
59920-0885
US

V. Phone/Fax

Practice location:
  • Phone: 406-213-9155
  • Fax:
Mailing address:
  • Phone: 406-213-9155
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-PCLC-LIC-88469
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: