Anderson Mangan, Lisa Rae

Anderson Mangan, Lisa Rae is an individual health care provider with primary practice located at 120 23Rd Ave Ne , Great Falls MT 59404-1445. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Anderson Mangan, Lisa Rae can be contacted via phone (406) 453-6784.

Contact Information

Primary practice address
120 23Rd Ave Ne Great Falls MT 59404-1445
Phone: (406) 453-6784
Fax: (406) 453-6793
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X LCPC 762 Montana

Profile Details

NPI number 1699772079
LBN Legal business name Anderson Mangan, Lisa Rae
Credentials LCPC
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2005
Last updated Apr 1st, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699772079 NPPES
Montana Other 074938 BLUE CROSS BLUE SHIELD
Montana MEDICAID 0252331 BLUE CROSS BLUE SHIELD

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