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General NPI Number Information
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NPI Number | 1912225061
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Entity Type | Individual
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Provider Name | CARLA A. GRUNDHAUSER LCSW, LCPC
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Gender | Female
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Dates
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Enumeration Date | 05/13/2010
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 918 2ND AVE
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City | LAUREL
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State | MT
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Zip | 59044-2017
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Country | US
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Telephone | 701-561-6033
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Fax |
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Provider Business Mailing Address
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Address Line | 918 2ND AVE
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City | LAUREL
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State | MT
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Zip | 59044-2017
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Country | US
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Telephone | 701-561-6033
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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 | BBH-LCPC-LIC-43588
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BBH-LCSW-LIC-85523
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License Number State | MT
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