Provider Demographics
NPI:1386073559
Name:ALLEN, JOSEPH (CMHC)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:
Last Name:ALLEN
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 DANIELSON RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-7252
Mailing Address - Country:US
Mailing Address - Phone:406-758-8100
Mailing Address - Fax:406-758-8150
Practice Address - Street 1:1605 DANIELSON RD
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-7252
Practice Address - Country:US
Practice Address - Phone:406-758-8100
Practice Address - Fax:406-758-8150
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6874797-6004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional