Provider Demographics
NPI:1306983242
Name:TWO RIVERS CENTER FOR HOLISTIC COUNSELING AND HEALING ARTZ
Entity type:Organization
Organization Name:TWO RIVERS CENTER FOR HOLISTIC COUNSELING AND HEALING ARTZ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:A
Authorized Official - Last Name:SCHICKENDANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-756-0887
Mailing Address - Street 1:PO BOX 10462
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:50094
Mailing Address - Country:US
Mailing Address - Phone:406-756-0887
Mailing Address - Fax:
Practice Address - Street 1:40 2ND ST E STE 223
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-6114
Practice Address - Country:US
Practice Address - Phone:406-756-0887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT708101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000255333Medicaid
MT744473OtherBLUE CROSS BLUE SHIELD
MT0000252671Medicaid
MT75436OtherBLUE CROSS BLUE SHIELD