Healthcare Provider Details

I. General information

NPI: 1386583490
Provider Name (Legal Business Name): WANDA M. SMITH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 WICKS LN STE 7A
BILLINGS MT
59105-4464
US

IV. Provider business mailing address

PO BOX 50686
BILLINGS MT
59105-0686
US

V. Phone/Fax

Practice location:
  • Phone: 406-690-1616
  • Fax:
Mailing address:
  • Phone: 406-690-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: WANDA BO SMITH
Title or Position: OWNER
Credential: LCPC
Phone: 406-690-1616