Healthcare Provider Details

I. General information

NPI: 1548391261
Provider Name (Legal Business Name): DARRYL L WEBER LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 11/13/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1643 LEWIS AVE SUITE 3
BILLINGS MT
59102-4151
US

IV. Provider business mailing address

PO BOX 22098
BILLINGS MT
59104-2098
US

V. Phone/Fax

Practice location:
  • Phone: 406-252-0713
  • Fax: 406-294-0967
Mailing address:
  • Phone: 406-252-0713
  • Fax: 406-294-0967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number383LCPC
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: