Healthcare Provider Details

I. General information

NPI: 1376664359
Provider Name (Legal Business Name): MICHAEL EDWARDS M.A., LCPC, LAC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2007
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 HOSPITAL WAY
WHITEFISH MT
59937-7858
US

IV. Provider business mailing address

1675 TALBOT RD
COLUMBIA FALLS MT
59912-4569
US

V. Phone/Fax

Practice location:
  • Phone: 406-862-1030
  • Fax:
Mailing address:
  • Phone: 406-892-3208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number650
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBBH-LAC-LIC-13219
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number736
License Number StateNH
# 4
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-LCPC-LIC-13148
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: