LOWELL OWEN WAVRICK (NPI# 1508380569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1508380569 |
Entity Type | Individual |
Full Name | LOWELL OWEN WAVRICK |
Credential | LAC |
Practice Address |
4998 Sonoma St Missoula MT 59808-8694 |
Practice Telephone | (406) 945-1730 |
Mailing Telephone | 4069451730 |
Enumeration Date | 2017-08-01 |
Last Update Date | 2017-08-01 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
BBH-LAC-LIC-2492 | MT | Behavioral Health & Social Service Providers |
Street Address |
4998 SONOMA ST |
City | MISSOULA |
State | MT |
Zip Code | 59808-8694 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1447720875 | Megan Elizabeth Galliford | Behavioral Analyst | 1647 Shindig Dr, Apt 303, Missoula, MT 59808 | 2018-11-28 |
1518473560 | Willow Mahana Nelson Griffith | Registered Nurse | 2829 Great Northern Loop Ste 300, Missoula, MT 59808 | 2017-12-28 |
1043739428 | Carol Elizabeth Mckenzie | Student in an Organized Health Care Education/Training Program | 2705 Oshaughnessy St, Missoula, MT 59808 | 2017-09-16 |
1558884064 | Sharon Marie Herndon | Nurse Practitioner | 2230 N Reserve St Ste 402, Missoula, MT 59808 | 2017-07-18 |
1427594761 | Erin Boggs | Specialist/Technologist | 2921 Dublin St, Missoula, MT 59808 | 2017-01-10 |
1942603287 | Benjamin Cody Mcintosh | Chiropractor | 1070 N. Russell St., Missoula, MT 59808 | 2014-10-01 |
1518219617 | Pure Medical Inc | Ambulance | 5515 Bonanza Place, Missoula, MT 59808 | 2012-10-12 |
1932462231 | Kathleen F Calcagno | Specialist/Technologist | 2615 Connery Way, Suite 2b, Missoula, MT 59808 | 2012-06-21 |
1639454127 | Dentyn Dunaway | Pharmacist | 2527 N Reserve Street, Missoula, MT 59808 | 2011-10-15 |
1750557690 | Carl Thornblade, Md, Pllc | Allergy & Immunology | 2801 Great Northern Loop Ste 101, Missoula, MT 59808 | 2008-04-30 |
Find all providers in zip 59808 |
Taxonomy Code | 101YA0400X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Addiction (Substance Use Disorder) |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1922667062 | Patrick Ryan | Counselor | 1335 Wyoming St, Missoula, MT 59801-1725 | 2019-06-12 |
1497237648 | Leigh Ann Christian Lcsw, Lac Pllc | Counselor | 127 N Higgins Ave Ste 307d, Missoula, MT 59802-4486 | 2018-09-04 |
1407346596 | Stepping Stones Counseling, Pllc | Counselor | 202 Brooks St Ste 300, Missoula, MT 59801 | 2018-05-14 |
1831686088 | Darren Baird Ashby | Counselor | 202 Brooks St, Missoula, MT 59801-4019 | 2018-04-13 |
1649720319 | Andrea J Foran | Counselor | 700 South Ave W Ste B, Missoula, MT 59801-8011 | 2016-10-06 |
1922557123 | Candace Mirea | Counselor | 2809 Connery Way Ste B, Missoula, MT 59808-1955 | 2016-09-28 |
1316312150 | Greta Jernberg | Counselor | 800 Kensington Ave Ste Ll2, Missoula, MT 59801-5670 | 2015-12-04 |
1851766745 | Kali Neumeister | Counselor | 136 E Broadway St Ste 16, Missoula, MT 59802-4505 | 2015-12-03 |
1124418298 | Ronald Emmanuel Barker | Counselor | 1119 W Kent Ave Ste C, Missoula, MT 59801-6633 | 2015-01-28 |
1972993319 | Emily Christine Anderson | Counselor | 6809 Sophie Dr, Missoula, MT 59803-3581 | 2015-01-23 |
Find all providers in MISSOULA |
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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.