Mavis Vaillancourt LCSW Lac LLC

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

MAVIS VAILLANCOURT LCSW LAC LLC

Practice address

415 Louisiana Ave
Libby, MT 59923-2131

Phone

(406) 546-8507

NPI assigned

Aug 8, 2016

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mavis Vaillancourt, LCSW LACNPI 1134139058

Title

Owner

Phone

(406) 546-8507

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mavis H. Vaillancourt, LCSW, LAC

  • Clinical Social Worker
  • Libby, MT
  • NPI 1134139058
  Medicare reassignment Authorized official
• Ann Brownback, LCSW

  • Clinical Social Worker
  • Libby, MT
  • NPI 1376585737
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1699229682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 LOUISIANA AVE",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 LOUISIANA AVE",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599232131",
            "telephone_number": "406-546-8507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAVIS VAILLANCOURT LCSW LAC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-08",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "VAILLANCOURT",
        "authorized_official_first_name": "MAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "406-546-8507",
        "authorized_official_credential": "LCSW LAC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julie Macdonald
• Elaine Rene Maggi, LCSW
• Michael L Mahoney, MD
• Jay Maloney, MD
• Jessica L Marsh, PTA
• Dorothy McBride
• Stevi Meade, PA-C
• Elise Mills, PA-C
• Mountain Rose Counseling
• My Hearing Centers, LLC

• Mental Health Clinic/Center (Including Community Mental Health Center) in Libby, MT
• Providers in Libby, MT by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.