Provider Demographics
NPI:1336419357
Name:STIMPFLING, ELISE M (LAC, BA)
Entity type:Individual
Prefix:
First Name:ELISE
Middle Name:M
Last Name:STIMPFLING
Suffix:
Gender:F
Credentials:LAC, BA
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 1974
Mailing Address - Street 2:
Mailing Address - City:THOMPSON FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59873-1974
Mailing Address - Country:US
Mailing Address - Phone:406-788-7505
Mailing Address - Fax:
Practice Address - Street 1:1312 N MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3095
Practice Address - Country:US
Practice Address - Phone:406-756-6453
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1418101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)