Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Ellie Victoria Shattuck, PCLC

Individual provider Mental Health Counselor · NPI 1962274662

Mrs. Ellie Victoria Shattuck, PCLC is a Mental Health Counselor in Bozeman, Montana. Practices as a sole proprietor. Licensed in Montana.

Licensed in
MT
In the registry since
2023
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Practice location Address checks out

1970 Stadium Dr Ste B
Bozeman, MT 59715-0623
Phone: (704) 574-0383
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence BBH-PCLC-LIC-48422 (MT)

Record details

NPI number1962274662
Entity typeIndividual (Type 1)
GenderFemale
Credentials PCLC
Sole proprietorYes
NPI enumeratedOctober 25, 2023
Last updated in NPPESOctober 25, 2023
Certification dateOctober 25, 2023

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