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:
Health care specialties
Specialty | Code | License # | 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 16 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1699772079 | NPPES |
Montana | Other | 074938 | BLUE CROSS BLUE SHIELD |
Montana | MEDICAID | 0252331 | BLUE CROSS BLUE SHIELD |
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