Healthcare Provider Details

I. General information

NPI: 1558432872
Provider Name (Legal Business Name): JULIE HECKER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2006
Last Update Date: 02/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2116 BROADWATER AVE SUITE #308
BILLINGS MT
59102-4774
US

IV. Provider business mailing address

PO BOX 21605
BILLINGS MT
59104-1605
US

V. Phone/Fax

Practice location:
  • Phone: 406-254-0125
  • Fax: 406-294-0967
Mailing address:
  • Phone: 406-254-0125
  • Fax: 406-294-0967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number521LCPC
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: