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General NPI Number Information
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NPI Number | 1114433505
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Entity Type | Individual
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Provider Name | CAROL M AHENAKEW MSW SWLC
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Gender | Female
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Dates
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Enumeration Date | 12/20/2017
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Last Update Date | 05/26/2023
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Provider Practice Location Address
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Address Line | 1609 PALM CT APT D
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City | GREAT FALLS
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State | MT
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Zip | 59405-5224
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Country | US
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Telephone | 406-471-7170
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Fax |
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Provider Business Mailing Address
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Address Line | 6850 UPPER BOX ELDER RD
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City | BOX ELDER
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State | MT
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Zip | 59521-9073
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Country | US
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Telephone | 406-395-4486
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Fax | 406-395-1797
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BBH-SWLC-LIC-23280
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License Number State | MT
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