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NPI Code Detail

MEDICARE: ALICJA MADLOCH

MEDICARE: ALICJA MADLOCH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorBBH-LCPC-LIC-88196MT

General Provider Information

NPI Number : 1073499430
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICJA MADLOCH
Provider Business Mailing Address
First Line : 1005 CARDINAL DR UNIT B
Second Line :
City : BELGRADE
State : MT
Zip : 59714-8373
Country : US
Telephone Number : 973-747-5434
Fax Number :
Provider Business Practice Location Address
First Line : 915 HIGHLAND BLVD
Second Line :
City : BOZEMAN
State : MT
Zip : 59715-6902
Country : US
Telephone Number : 406-414-5840
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2025
Last Update Date : 06/09/2026

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Directions to “ ALICJA MADLOCH ” Practice Location

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