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General NPI Number Information
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NPI Number | 1598464356
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Entity Type | Individual
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Provider Name | MICHAEL BRANDON PELFREY
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Gender | Male
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Dates
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Enumeration Date | 03/01/2023
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Last Update Date | 03/01/2023
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Provider Practice Location Address
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Address Line | 1138 1ST AVE E
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City | KALISPELL
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State | MT
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Zip | 59901-5604
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Country | US
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Telephone | 803-517-9467
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Fax |
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Provider Business Mailing Address
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Address Line | 1138 1ST AVE E
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City | KALISPELL
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State | MT
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Zip | 59901-5604
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Country | US
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Telephone | 803-517-9467
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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 | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 62306
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License Number State | MT
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 56139
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License Number State | MT
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