MEDICARE: AMY ESMAY

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	101YM0800X	Mental Health Counselor	SWP-LCPC-LIC-7655	MT

General Provider Information

NPI Number	:	1649696493
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY ESMAY

Provider Business Mailing Address
First Line	:	PO BOX 1145
Second Line	:
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-1145
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1805 9TH ST W
Second Line	:	SUITE D
City	:	COLUMBIA FALLS
State	:	MT
Zip	:	59912-4410
Country	:	US
Telephone Number	:	406-892-3063
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/17/2014
Last Update Date	:	10/14/2016

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Directions to “ AMY ESMAY ” Practice Location

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