PAMELA BEATRICE LICCARDI (NPI# 1063989275) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063989275 |
| Entity Type | Individual |
| Full Name | PAMELA BEATRICE LICCARDI |
| Credential | PCLC/ACLC |
| Practice Address |
285 2nd Avenue West N Kalispell MT 59901-3910 |
| Mailing Address |
1701 Bluestone Dr Unit B Kalispell MT 59901-7556 |
| Practice Telephone | 4068902570 |
| Mailing Telephone | 4064078911 |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2018-10-25 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 32924 | MT | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
32949 | MT | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
32924 | MT | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
32924 | MT | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1701 Bluestone Dr Unit B, Kalispell, MT 599017556 | 4064078911 | |
| 3662 14 3rd St E, Kalispell, MT 59901 | 4064078911 |
| Street Address |
285 2ND AVENUE WEST N |
| City | KALISPELL |
| State | MT |
| Zip Code | 59901-3910 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275810947 | Gary Kent | Counselor | 285 2nd Avenue West N, Kalispell, MT 59901-3910 | 2011-11-09 |
| 1801419908 | Stefan M Spies | Counselor | 285 2nd Avenue West N, Kalispell, MT 59901-3910 | 2020-05-22 |
| 1134750318 | Summer Rae Laven | Counselor | 285 2nd Avenue West N, Kalispell, MT 59901-3910 | 2020-01-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982226650 | Mountain Physical Therapy and Fitness Center LLC | Physical Medicine & Rehabilitation | 2593 Highway 2 East, Suite 6, Kalispell, MT 59901 | 2020-05-15 |
| 1164058350 | Jessica Leeann Abell | Physical Therapist | 1825 Highway 93 S. Suite C, Kalispell, MT 59901 | 2020-03-19 |
| 1588216535 | Diversified Therapeutic Services, Pllc | Clinic/Center | 30 E Washinton St, Suite A, Kalispell, MT 59901 | 2019-07-10 |
| 1467986216 | Jill Shaver | Counselor | 285 2nd Avenue Wn, Suite #100, Kalispell, MT 59901 | 2017-04-19 |
| 1003270810 | Angela Otto | Counselor | 17 2nd St E Ste 204, Kalispell, MT 59901 | 2016-04-07 |
| 1548626989 | Pamela Greskowiak | Counselor | 2282 Hwy 93 South, Suite #1, Kalispell, MT 59901 | 2016-01-14 |
| 1063894921 | Joel Booth | Dentist | 690 N Meridian Rd Ste 106, Kalispell, MT 59901 | 2015-06-26 |
| 1982085841 | Heather Reddig | Specialist | 751 Snowberry Trail, Kalispell, MT 59901 | 2015-06-16 |
| 1497147193 | Patricia Greene Hall | Psychologist | 1035 1st Ave W Fl 3, Kalispell, MT 59901 | 2015-03-04 |
| 1720478886 | Lori Mariani | Social Worker | 1605 Danielson Road, Kalispell, MT 59901 | 2015-01-28 |
| Find all providers in zip 59901 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215544705 | Mary Beth Mcrae | Counselor | 412 3rd Ave W, Kalispell, MT 59901-4804 | 2020-09-28 |
| 1538793260 | Trishia Ann Pollard | Counselor | 552 3rd Avenue West N, Kalispell, MT 59901-3616 | 2020-03-03 |
| 1548812696 | Carrie S Burnham | Counselor | 17 2nd St E Ste 212, Kalispell, MT 59901-4500 | 2019-07-09 |
| 1366901266 | Philip Lodien | Counselor | 723 5th Ave. East, St. B18, Kalispell, MT 59901-5990 | 2019-03-19 |
| 1174008155 | Thoughtful Endeavors Counseling LLC | Counselor | 30 5th St E Ste 101, Kalispell, MT 59901-4970 | 2018-09-26 |
| 1114420171 | Roy Walter Mcdaniel | Counselor | 723 5th Ave E Ste B-18, Kalispell, MT 59901-5321 | 2018-03-15 |
| 1174041206 | Thrivology, Inc. | Counselor | 723 5th Ave E # B18, Kalispell, MT 59901-5321 | 2017-09-08 |
| 1659891349 | Lorraine Hellman-robertson | Counselor | 2150 Mt Highway 35, Kalispell, MT 59901-7779 | 2017-06-22 |
| 1225568280 | Lisa A Johnson | Counselor | 43 Woodland Park Dr Ste 5, Kalispell, MT 59901-4676 | 2017-06-13 |
| 1952761470 | Megan K Baker Welles | Counselor | 145 Northridge Dr, Kalispell, MT 59901-2634 | 2016-02-25 |
| Find all providers in KALISPELL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.