Provider Demographics
NPI:1215646971
Name:DOGWOOD COUNSELING PLLC
Entity type:Organization
Organization Name:DOGWOOD COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:K
Authorized Official - Last Name:NEWELL WYATT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-210-0035
Mailing Address - Street 1:PO BOX 1382
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-1382
Mailing Address - Country:US
Mailing Address - Phone:406-210-0035
Mailing Address - Fax:406-635-8695
Practice Address - Street 1:302 1ST ST W STE 104
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-2602
Practice Address - Country:US
Practice Address - Phone:406-210-0035
Practice Address - Fax:406-635-8695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-21
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty