Provider Demographics
NPI:1275376931
Name:PERLICK, MICHELLE (SWLC)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:PERLICK
Suffix:
Gender:F
Credentials:SWLC
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 907
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-0907
Mailing Address - Country:US
Mailing Address - Phone:406-442-4130
Mailing Address - Fax:
Practice Address - Street 1:1048 N 30TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0732
Practice Address - Country:US
Practice Address - Phone:406-442-4130
Practice Address - Fax:406-442-4192
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-71425101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor