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NPI Code Detail

MEDICARE: MS. DEBRA LYNN HALLOS LCPC

MEDICARE:  MS. DEBRA LYNN HALLOS  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
1101YP2500XProfessional Counselor#847MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
275438OTHERMTBLUE CROSS/ BLUE SHIELD

General Provider Information

NPI Number : 1740213420
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. DEBRA LYNN HALLOS LCPC
Provider Business Mailing Address
First Line : 11 BITTERROOT MOUNTAIN RD
Second Line :
City : CLANCY
State : MT
Zip : 59634-9631
Country : US
Telephone Number : 406-390-6488
Fax Number :
Provider Business Practice Location Address
First Line : 11 BITTERROOT MOUNTAIN RD
Second Line :
City : CLANCY
State : MT
Zip : 59634-9631
Country : US
Telephone Number : 406-390-6488
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2006
Last Update Date : 08/09/2023

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