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General NPI Number Information
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NPI Number | 1174310585
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Entity Type | Individual
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Provider Name | LAUREN MCCRILLIS PCLC
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Gender | Female
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Dates
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Enumeration Date | 04/21/2025
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 127 N HIGGINS AVE STE 202
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City | MISSOULA
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State | MT
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Zip | 59802-4457
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Country | US
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Telephone | 406-201-1266
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Fax |
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Provider Business Mailing Address
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Address Line | 336 S 6TH ST W APT 11
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City | MISSOULA
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State | MT
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Zip | 59801-3956
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Country | US
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Telephone | 406-550-2903
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Fax |
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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 | BBH-PCLC-LIC-63197
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License Number State | MT
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