Individual provider · Type 1 NPI

Ellie Victoria Shattuck, PCLC

Mental Health Counselor · Bozeman, MT

NPI number 1962274662 Active

Practice location

1970 Stadium Dr Ste B
Bozeman, MT 59715-0623

Call (704) 574-0383 Map

Mailing address

500 Westgate Ave
Bozeman, MT 59718-2503

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XBBH-PCLC-LIC-48422 (MT)

Mental Health Counselor: Definition to come...

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About NPI 1962274662

Ellie Victoria Shattuck, PCLC's National Provider Identifier is 1962274662, issued on Oct 25, 2023. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Bozeman, MT. The record was last updated on Oct 25, 2023.