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General NPI Number Information
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NPI Number | 1265407621
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Entity Type | Individual
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Provider Name | JAMEY LYNN IVEY LCPC
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 915 1ST AVE S CENTER FOR MENTAL HEALTH
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City | GREAT FALLS
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State | MT
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Zip | 59401-3705
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Country | US
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Telephone | 406-791-9533
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Fax | 406-761-2107
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Provider Business Mailing Address
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Address Line | PO BOX 32
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City | FORT SHAW
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State | MT
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Zip | 59443-0032
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Country | US
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Telephone | 406-264-5214
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 1194 LCPC
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License Number State | MT
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