Healthcare Provider Details

I. General information

NPI: 1447533666
Provider Name (Legal Business Name): LYNN STEWART L.P.C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2011
Last Update Date: 11/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

546 SOUTH AVE W
MISSOULA MT
59801-8015
US

IV. Provider business mailing address

445 BURLINGTON AVE
MISSOULA MT
59801-5739
US

V. Phone/Fax

Practice location:
  • Phone: 406-240-7229
  • Fax:
Mailing address:
  • Phone: 406-240-7229
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number199
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number199
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number199
License Number StateMT
# 4
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number199
License Number StateMT
# 5
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number199
License Number StateMT
# 6
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number199
License Number StateMT
# 7
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number199
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: