Provider Demographics
NPI:1306341862
Name:ROWELL, SALIE MARISE (LCPC, NCC)
Entity type:Individual
Prefix:MS
First Name:SALIE
Middle Name:MARISE
Last Name:ROWELL
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:MS
Other - First Name:MARISE
Other - Middle Name:COTTON
Other - Last Name:ROWELL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCPC, NCC
Mailing Address - Street 1:4055 VALLEY COMMONS DR STE H
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-6434
Mailing Address - Country:US
Mailing Address - Phone:406-219-5600
Mailing Address - Fax:
Practice Address - Street 1:4055 VALLEY COMMONS DR STE H
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-6434
Practice Address - Country:US
Practice Address - Phone:406-219-5600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-27
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-254455101Y00000X
MTBBH-LCPC-LIC-25443101YA0400X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty