MEDICARE: DR. AMBRIN MASOOD PHD, LCPC

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	101YP2500X	Professional Counselor	BBH-LCPC-LIC-55288	MT

General Provider Information

NPI Number	:	1700593340
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMBRIN MASOOD PHD, LCPC

Provider Business Mailing Address
First Line	:	2514 LAKE HEIGHTS DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-3509
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2514 LAKE HEIGHTS DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-3509
Country	:	US
Telephone Number	:	406-690-9231
Fax Number	:

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

Provider Enumeration Date	:	11/02/2022
Last Update Date	:	11/02/2022

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