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General NPI Number Information
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NPI Number | 1992167175
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Entity Type | Individual
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Provider Name | MARY PIKE LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/25/2016
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Last Update Date | 03/25/2016
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Provider Practice Location Address
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Address Line | 1045 N 30TH ST
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City | BILLINGS
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State | MT
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Zip | 59101-0733
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Country | US
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Telephone | 406-657-3988
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Fax | 406-657-3945
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Provider Business Mailing Address
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Address Line | 12775 MEDICINE MAN TRL
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City | MOLT
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State | MT
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Zip | 59057-2187
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Country | US
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Telephone | 406-690-4188
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Fax | 406-657-3945
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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 | 689
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License Number State | MT
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