Healthcare Provider Details

I. General information

NPI: 1326971318
Provider Name (Legal Business Name): NORTHERN LIGHTS MENTAL HEALTH & WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 CRESTVIEW DR UNIT 204
BIGFORK MT
59911-3594
US

IV. Provider business mailing address

104 CRESTVIEW DR UNIT 204
BIGFORK MT
59911-3594
US

V. Phone/Fax

Practice location:
  • Phone: 406-210-2502
  • Fax: 406-730-6169
Mailing address:
  • Phone: 406-210-2502
  • Fax: 406-730-6169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LAUREN COLEY
Title or Position: OWNER
Credential: PMHNP-BC
Phone: 406-210-2502