Provider Demographics
NPI:1538264643
Name:SISSON, ALETA L (LCPC)
Entity type:Individual
Prefix:MRS
First Name:ALETA
Middle Name:L
Last Name:SISSON
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 S 5TH ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-2700
Mailing Address - Country:US
Mailing Address - Phone:406-363-3353
Mailing Address - Fax:406-363-3353
Practice Address - Street 1:120 S 5TH ST
Practice Address - Street 2:SUITE 204
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-2700
Practice Address - Country:US
Practice Address - Phone:406-363-3353
Practice Address - Fax:406-363-3353
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT886101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT742030OtherBCBSMT
MT0254167Medicaid