Basic Information
| Provider Information | |||||||||
| NPI: | 1760806244 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TIPTON | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | LCPC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3212 1ST AVE S | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591013814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062452751 | ||||||||
| FaxNumber: | 4062567026 | ||||||||
| Practice Location | |||||||||
| Address1: | 3212 1ST AVE S | ||||||||
| Address2: | |||||||||
| City: | BILLINGS | ||||||||
| State: | MT | ||||||||
| PostalCode: | 591013814 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4062452751 | ||||||||
| FaxNumber: | 4062567026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2014 | ||||||||
| LastUpdateDate: | 02/05/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | SWP-LCPC-LIC-6444 | MT | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.