Provider Demographics
NPI:1871722645
Name:AASHEIM, GINA ELIZABETH (LCPC)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:ELIZABETH
Last Name:AASHEIM
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 1:110 GRANT ST STE B
Mailing Address - Street 2:P.O. BOX 412
Mailing Address - City:PLENTYWOOD
Mailing Address - State:MT
Mailing Address - Zip Code:59254-1810
Mailing Address - Country:US
Mailing Address - Phone:406-765-1277
Mailing Address - Fax:406-765-1278
Practice Address - Street 1:110 GRANT ST STE B
Practice Address - Street 2:
Practice Address - City:PLENTYWOOD
Practice Address - State:MT
Practice Address - Zip Code:59254
Practice Address - Country:US
Practice Address - Phone:406-765-1277
Practice Address - Fax:406-765-1278
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-14
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1429101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health