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NPI 1588786024

NPI 1588786024 : LORI HAFNER PIKE LCSW : GREAT FALLS, MT

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General NPI Number Information
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    NPI Number           |    1588786024
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    Entity Type          |    Individual 
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    Provider Name        |    LORI HAFNER PIKE LCSW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    04/04/2007
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    Last Update Date     |    07/10/2007
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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            |    406-791-9535
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    Fax                  |    406-761-2107
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Provider Business Mailing Address
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    Address Line         |    1220 3RD AVE N 
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    City                 |    GREAT FALLS
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    State                |    MT
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    Zip                  |    59401-1438
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    Country              |    US
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    Telephone            |    406-799-1895
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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        |    1041C0700X
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    Taxonomy Name        |    Clinical Social Worker
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    License Number       |    784
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    License Number State |    MT
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