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General NPI Number Information
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NPI Number | 1265943559
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Entity Type | Organization
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Legal Business Name | ELIZABETH URSCHEL, LCSW, LLC
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Dates
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Enumeration Date | 10/13/2017
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Last Update Date | 10/13/2017
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Provider Practice Location Address
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Address Line | 725 W ALDER ST STE 2
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City | MISSOULA
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State | MT
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Zip | 59802-4094
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Country | US
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Telephone | 406-493-4747
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7734
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City | MISSOULA
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State | MT
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Zip | 59807-7734
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ELIZABETH URSCHEL
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Credential | LCSW
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Telephone | 406-493-4747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BBH-LCSW-LIC-25295
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License Number State | MT
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