Provider Demographics
NPI:1194762401
Name:STEMBORSKI, MICHAEL (LCPC, LAC)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:STEMBORSKI
Suffix:
Gender:M
Credentials:LCPC, LAC
Other - Prefix:
Other - First Name:MICK
Other - Middle Name:
Other - Last Name:STEMBORSKI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW, LAC
Mailing Address - Street 1:1611 N FORK RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-9410
Mailing Address - Country:US
Mailing Address - Phone:406-892-8830
Mailing Address - Fax:
Practice Address - Street 1:1611 N FORK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:COLUMBIA FALLS
Practice Address - State:MT
Practice Address - Zip Code:59912-9410
Practice Address - Country:US
Practice Address - Phone:406-892-8830
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1183101YA0400X
MT1103101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT742670OtherBLUE CROSS