MEDICARE: NICHOLE ARDEN DAVALOS

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	57040	MT
2	101YP2500X	Professional Counselor	57040	MT

General Provider Information

NPI Number	:	1366316267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICHOLE ARDEN DAVALOS

Provider Business Mailing Address
First Line	:	313 SKYLINE DR NE
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1024
Country	:	US
Telephone Number	:	406-231-3336
Fax Number	:

Provider Business Practice Location Address
First Line	:	313 SKYLINE DR NE
Second Line	:
City	:	GREAT FALLS
State	:	MT
Zip	:	59404-1024
Country	:	US
Telephone Number	:	406-231-3336
Fax Number	:

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

Provider Enumeration Date	:	10/02/2025
Last Update Date	:	10/02/2025

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Directions to “ NICHOLE ARDEN DAVALOS ” Practice Location

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