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General NPI Number Information
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NPI Number | 1700334489
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Entity Type | Individual
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Provider Name | ELAINE NOLAND-SEPKO LCPC
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Gender | Female
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Dates
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Enumeration Date | 09/12/2016
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Last Update Date | 03/06/2023
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Provider Practice Location Address
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Address Line | 1409 GRANITE CT
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City | MISSOULA
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State | MT
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Zip | 59801-7082
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Country | US
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Telephone | 406-240-1877
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Fax |
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Provider Business Mailing Address
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Address Line | 1409 GRANITE CT
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City | MISSOULA
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State | MT
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Zip | 59801-7082
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Country | US
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Telephone | 406-240-1877
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LH61311643
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 6401223000
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC-2136
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License Number State | WY
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | BBH-LCPC-LIC-19130
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License Number State | MT
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