MEDICARE: CARR COUNSELING LLC

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
1	251S00000X	Community/Behavioral Health Agency	617LCSW	MT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215126289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARR COUNSELING LLC

Provider Business Mailing Address
First Line	:	PO BOX 615
Second Line	:
City	:	MADISON
State	:	WI
Zip	:	53701-0615
Country	:	US
Telephone Number	:	406-212-2549
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 E WASHINGTON ST
Second Line	:	STE A
City	:	KALISPELL
State	:	MT
Zip	:	59901-3967
Country	:	US
Telephone Number	:	406-212-2549
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. KRISTI LEA CARR
Credential	:	MSSW, LCSW
Telephone Number	:	406-212-2549

Provider Enumeration Date	:	10/16/2007
Last Update Date	:	09/10/2010

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