Provider Demographics
NPI:1114716230
Name:DOLAN, EMILY (PCLC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:DOLAN
Suffix:
Gender:
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 US HIGHWAY 2 W STE A
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-3499
Mailing Address - Country:US
Mailing Address - Phone:406-201-1616
Mailing Address - Fax:
Practice Address - Street 1:1325 US HIGHWAY 2 W STE A
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3499
Practice Address - Country:US
Practice Address - Phone:928-308-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-79316101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health