Provider Demographics
NPI:1063518041
Name:LOMBARDI, SUSAN PATTI (LCPC)
Entity type:Individual
Prefix:MRS
First Name:SUSAN
Middle Name:PATTI
Last Name:LOMBARDI
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1238
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-1238
Mailing Address - Country:US
Mailing Address - Phone:406-862-2784
Mailing Address - Fax:406-862-4845
Practice Address - Street 1:100 2ND ST E
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2410
Practice Address - Country:US
Practice Address - Phone:406-862-2784
Practice Address - Fax:406-862-2784
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT978101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional