Provider Demographics
NPI:1972993319
Name:ANDERSON, EMILY CHRISTINE (MA, LCPC, LAC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:CHRISTINE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA, LCPC, LAC
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 882
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-0882
Mailing Address - Country:US
Mailing Address - Phone:720-333-7378
Mailing Address - Fax:
Practice Address - Street 1:725 SW HIGGINS AVE STE B
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1420
Practice Address - Country:US
Practice Address - Phone:406-298-5181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-23
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT39957101YA0400X
MT38711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)