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General NPI Number Information
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NPI Number | 1831135359
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Entity Type | Individual
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Provider Name | PAULA LYNN EHRMANTRAUT MS MED LCPC CSP
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Gender | Female
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Dates
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Enumeration Date | 06/22/2006
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 514 AMERICAS WAY PMB 2333
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City | BOX ELDER
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State | SD
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Zip | 57719
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Country | US
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Telephone | 406-853-6020
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Fax |
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Provider Business Mailing Address
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Address Line | 514 AMERICAS WAY PMB 2333
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City | BOX ELDER
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State | SD
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Zip | 57719
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Country | US
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Telephone | 406-853-6020
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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 | 1196 LCPC
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License Number State | MT
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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 | 12837443-6004
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License Number State | UT
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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-MH30682
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License Number State | SD
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