Healthcare Provider Details

I. General information

NPI: 1841009727
Provider Name (Legal Business Name): BETHANY DIRKSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/04/2025
Last Update Date: 01/04/2025
Certification Date: 01/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N BROADWAY STE 423
BILLINGS MT
59101-1943
US

IV. Provider business mailing address

2222 NINA CLARE RD
BILLINGS MT
59102-2140
US

V. Phone/Fax

Practice location:
  • Phone: 406-896-8427
  • Fax:
Mailing address:
  • Phone: 406-839-8282
  • 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:
Title or Position:
Credential:
Phone: