Provider Demographics
NPI:1447635867
Name:GWEN SENSENIG LCSW THERAPIST LLC
Entity type:Organization
Organization Name:GWEN SENSENIG LCSW THERAPIST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SENSENIG
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:907-306-4161
Mailing Address - Street 1:826 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3715
Mailing Address - Country:US
Mailing Address - Phone:907-306-4161
Mailing Address - Fax:
Practice Address - Street 1:825 HELENA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3459
Practice Address - Country:US
Practice Address - Phone:907-306-4161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-27
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTC264221251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health