Healthcare Provider Details

I. General information

NPI: 1689949133
Provider Name (Legal Business Name): TAMARACK GRIEF RESOURCE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/16/2012
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 S 1ST ST W
MISSOULA MT
59801-1850
US

IV. Provider business mailing address

405 S 1ST ST W
MISSOULA MT
59801-1850
US

V. Phone/Fax

Practice location:
  • Phone: 406-541-8472
  • Fax: 406-926-1152
Mailing address:
  • Phone: 406-541-8472
  • Fax: 406-926-1152

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE BARRETT
Title or Position: EXECUTIVE DIRECTOR
Credential: ED.D., LCPC
Phone: 406-541-8472