MEDICARE: INDIGO THERAPY PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1285522680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIGO THERAPY PLLC

Provider Business Mailing Address
First Line	:	1436 RAILROAD HWY
Second Line	:
City	:	BALLANTINE
State	:	MT
Zip	:	59006-9775
Country	:	US
Telephone Number	:	406-780-7439
Fax Number	:

Provider Business Practice Location Address
First Line	:	1436 RAILROAD HWY
Second Line	:
City	:	BALLANTINE
State	:	MT
Zip	:	59006-9775
Country	:	US
Telephone Number	:	406-894-0208
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ZARA S HANSON
Credential	:	LCSW
Telephone Number	:	406-894-0208

Provider Enumeration Date	:	06/25/2025
Last Update Date	:	12/04/2025

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Directions to “INDIGO THERAPY PLLC ” Practice Location

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