MEDICARE: GRACE NICOLE ALDEEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	BBH-LCPC-LIC-81838	MT

General Provider Information

NPI Number	:	1245109446
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRACE NICOLE ALDEEN

Provider Business Mailing Address
First Line	:	3010 SANTA FE CT OFC 123
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-1730
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3010 SANTA FE CT OFC 123
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59808-1730
Country	:	US
Telephone Number	:	563-210-9365
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/04/2025
Last Update Date	:	06/19/2026

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Directions to “ GRACE NICOLE ALDEEN ” Practice Location

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