MS. LISA RAE ANDERSON MANGAN (NPI# 1699772079) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699772079 |
| Entity Type | Individual |
| Full Name | MS. LISA RAE ANDERSON MANGAN |
| Credential | LCPC |
| Practice Address |
120 23rd Ave Ne Great Falls MT 59404-1445 |
| Practice Telephone | 4064536784 |
| Practice Fax Number | 4064536793 |
| Mailing Telephone | 4064536784 |
| Mailing Fax Number | 4064536793 |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2008-04-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
LCPC 762 | MT | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 0252331 | 05 | |
| MT | BLUE CROSS BLUE SHIELD | 074938 | 01 |
| Street Address |
120 23RD AVE NE |
| City | GREAT FALLS |
| State | MT |
| Zip Code | 59404-1445 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477550549 | Elisabeth Montana Purdy | Counselor | 120 23rd Ave Ne, Great Falls, MT 59404-1445 | 2005-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629504154 | Shawna Renee Applegate | Nurse Practitioner | 115 4th St S., Great Falls, MT 59404 | 2017-05-03 |
| 1093267213 | Cara Firman | Counselor | 3300 3rd St Ne, Great Falls, MT 59404 | 2016-11-04 |
| 1457803900 | Benjamin Huempfner | Counselor | 1205 1st Ave Nw, Great Falls, MT 59404 | 2016-11-01 |
| 1649675471 | Stephen Trautman | Pharmacist | 1000 3rd Steet Nw, Great Falls, MT 59404 | 2014-10-22 |
| 1457765851 | Complete Eye Care Pllc | Optometrist | 1012 1st Ave Nw, Great Falls, MT 59404 | 2014-06-13 |
| 1871923714 | William Joshu | Physician Assistant | 25 14th Avenue N.w., Great Falls, MT 59404 | 2013-11-13 |
| 1679839369 | Joelene Sharon (o'neill) Goodover | Counselor | 803 Forest Ave., Great Falls, MT 59404 | 2012-04-06 |
| 1942512728 | Amy Jo Jamieson | Counselor | 600 Ave. A, Valley View School, Great Falls, MT 59404 | 2010-07-08 |
| 1942527890 | Matthew Clayton Taecker | Emergency Medicine | 113 38th Ave Ne, Great Falls, MT 59404 | 2010-04-30 |
| 1720212897 | Dana Marie Thompson | Military Health Care Provider | 819 Rhs/sg, 6944 Goddard Drive, Malmstrom Afb, MT 59404 | 2009-05-05 |
| Find all providers in zip 59404 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790328573 | Amanda M Walker | Counselor | 1601 2nd Ave N Ste 200a, Great Falls, MT 59401-3243 | 2019-10-23 |
| 1124519491 | Destiny Freiburg | Counselor | 417 Central Ave Ste 2b, Great Falls, MT 59401-3162 | 2018-05-22 |
| 1366956898 | Lela May Zuck | Counselor | 600 Central Ave Ste 312, Great Falls, MT 59401-3141 | 2017-11-20 |
| 1902322266 | Tanya L Richem | Counselor | 1324 Central Ave W Ste 6, Great Falls, MT 59404-3971 | 2017-08-18 |
| 1760902886 | Patty Sisk Goodmundson | Counselor | 225 7th Ave S, Great Falls, MT 59405-1820 | 2017-06-20 |
| 1245772920 | Believe Therapeutic Services | Counselor | 1601 2nd Ave N Ste 450-i, Great Falls, MT 59401-3259 | 2016-11-10 |
| 1528500402 | Jacqueline Woyth | Counselor | 2501 6th St Nw, Great Falls, MT 59404-1300 | 2016-11-09 |
| 1093267213 | Cara Firman | Counselor | 3300 3rd St Ne, Great Falls, MT 59404 | 2016-11-04 |
| 1710429956 | Kenneth Engelhardt | Counselor | 2501 2nd Avenue North, Great Falls, MT 59401 | 2016-11-04 |
| 1487106928 | Nicole Dresch | Counselor | 3420 15th Ave South, Great Falls, MT 59405 | 2016-11-01 |
| Find all providers in GREAT FALLS | ||||
| City | GREAT FALLS |
| Zip Code | 59404 |
Please comment or provide details below to improve the information on MS. LISA RAE ANDERSON MANGAN.
| 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.