Healthcare Provider Details

I. General information

NPI: 1235060625
Provider Name (Legal Business Name): CHEYANNE NICHOLE CARL PCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 2ND AVE N STE 160
BILLINGS MT
59101-2060
US

IV. Provider business mailing address

3333 2ND AVE N STE 160
BILLINGS MT
59101-2060
US

V. Phone/Fax

Practice location:
  • Phone: 406-213-3313
  • Fax: 406-296-5282
Mailing address:
  • Phone: 406-213-3313
  • Fax: 406-296-5282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-PCLC-LIC-88869
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: