Healthcare Provider Details

I. General information

NPI: 1417797580
Provider Name (Legal Business Name): MEGAN ELIZABETH ROSENBERG LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2024
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 S MAIN ST STE 49
KALISPELL MT
59901-1498
US

IV. Provider business mailing address

PO BOX 9352
MISSOULA MT
59807-9352
US

V. Phone/Fax

Practice location:
  • Phone: 406-369-7700
  • Fax:
Mailing address:
  • Phone: 406-369-7700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-70934
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: