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General NPI Number Information
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NPI Number | 1376333906
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Entity Type | Organization
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Legal Business Name | 1UP COUNSELING
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Dates
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Enumeration Date | 05/07/2025
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Last Update Date | 07/02/2025
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Provider Practice Location Address
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Address Line | 710 DRAKE ST
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City | WIBAUX
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State | MT
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Zip | 59353-9086
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Country | US
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Telephone | 406-795-3988
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 562
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City | BEACH
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State | ND
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Zip | 58621-0562
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Country | US
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Telephone | 701-872-6152
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Fax |
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Authorized Official
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Title or Position | LICENSED COUNSELOR
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Name | JUSTUS GARNEAU
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Credential | LCPC, LPC
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Telephone | 701-872-6152
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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 |
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License Number State |
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