Healthcare Provider Details

I. General information

NPI: 1578370870
Provider Name (Legal Business Name): AMY ELIZABETH COLLINS PCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 S 25TH ST W STE 2
BILLINGS MT
59102-7417
US

IV. Provider business mailing address

1050 S 25TH ST W STE 2
BILLINGS MT
59102-7417
US

V. Phone/Fax

Practice location:
  • Phone: 406-560-2477
  • Fax: 406-656-0935
Mailing address:
  • Phone: 406-560-2477
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-PCLC-LIC-75197
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: