Provider Demographics
NPI:1104644558
Name:DESJARLAIS, ALISON TAYLOR (MS, LCPC)
Entity type:Individual
Prefix:MRS
First Name:ALISON
Middle Name:TAYLOR
Last Name:DESJARLAIS
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3240 DREDGE DR
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0548
Mailing Address - Country:US
Mailing Address - Phone:406-491-1732
Mailing Address - Fax:
Practice Address - Street 1:3240 DREDGE DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0548
Practice Address - Country:US
Practice Address - Phone:406-457-4758
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-72679101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor