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General NPI Number Information
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NPI Number | 1114894821
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Entity Type | Organization
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Legal Business Name | INNERTHREAD PLLC
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Dates
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Enumeration Date | 10/20/2025
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 406 MAIN ST
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City | WOLF POINT
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State | MT
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Zip | 59201-1534
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Country | US
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Telephone | 406-688-9740
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Fax |
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Provider Business Mailing Address
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Address Line | 283 MENDENHALL RD
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City | WOLF POINT
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State | MT
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Zip | 59201-7128
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Country | US
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Telephone | 406-688-9740
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Fax |
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Authorized Official
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Title or Position | MANAGER/ CREDENTIAL SPECIALIST
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Name | CORDIE M LICCIARDI
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Credential |
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Telephone | 701-580-4091
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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