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General NPI Number Information
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NPI Number | 1003273533
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Entity Type | Organization
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Legal Business Name | NCENTER
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 21000 FRONTAGE RD #13
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City | BELGRADE
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State | MT
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Zip | 59714-8547
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Country | US
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Telephone | 406-599-2492
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Fax | 406-577-2085
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Provider Business Mailing Address
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Address Line | 21000 FRONTAGE RD #13
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City | BELGRADE
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State | MT
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Zip | 59714-8547
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Country | US
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Telephone | 406-599-2492
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Fax | 406-577-2085
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | DEMETRI JAN MATNEY
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Credential | LCPC
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Telephone | 406-599-2492
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 326
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License Number State | MT
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