Provider Demographics
NPI:1649938747
Name:CENTERED IN THE WEST, PLLC
Entity type:Organization
Organization Name:CENTERED IN THE WEST, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:REGISTERED AGENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:WAY
Authorized Official - Last Name:WATHEN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:701-566-9457
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-0725
Mailing Address - Country:US
Mailing Address - Phone:701-566-9457
Mailing Address - Fax:
Practice Address - Street 1:111 N HIGGINS AVE STE 419
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4433
Practice Address - Country:US
Practice Address - Phone:701-566-9457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-06
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty