Vincent John Antonick, LAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Helena, MT
NPI 1992470371 · NPPES record last updated Aug 9, 2021
Key facts
- NPI
- 1992470371
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 49997 (MT)
- Practice address
- 501 Euclid Ave
Helena, MT 59601-2865 - Phone
- (406) 449-5796
- NPI assigned
- Aug 9, 2021
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49997 | MT | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 49997 | MT | Yes |
Addresses
Primary practice location
501 Euclid Ave
Helena, MT 59601-2865
Mailing address
501 Euclid Ave
Helena, MT 59601-2865
Phone (406) 449-5796
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 49997 | Other | MT | LICENSED ADDICTIONS COUNSELOR |
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.