Healthcare Provider Details

I. General information

NPI: 1881522803
Provider Name (Legal Business Name): LACIE KAY STIVERS LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2026
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1231 N 29TH ST
BILLINGS MT
59101-0147
US

IV. Provider business mailing address

608 N 30TH ST APT 3B
BILLINGS MT
59101-1161
US

V. Phone/Fax

Practice location:
  • Phone: 406-248-3175
  • Fax:
Mailing address:
  • Phone: 406-598-8842
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBBH-LAC-LIC-88712
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: