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NPI Code Detail

MEDICARE: MICOLE FOUST LACOUNTE ACLC

MEDICARE: MICOLE FOUST LACOUNTE ACLC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorBBH-ACLC-LIC-63769MT

General Provider Information

NPI Number : 1962970590
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICOLE FOUST LACOUNTE ACLC
Provider Business Mailing Address
First Line : 2620 CONNERY WAY
Second Line :
City : MISSOULA
State : MT
Zip : 59808-1325
Country : US
Telephone Number : 406-203-9948
Fax Number : 406-203-9949
Provider Business Practice Location Address
First Line : 2620 CONNERY WAY
Second Line :
City : MISSOULA
State : MT
Zip : 59808-1325
Country : US
Telephone Number : 406-203-9948
Fax Number : 406-203-9949
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/13/2018
Last Update Date : 05/27/2025

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