Healthcare Provider Details

I. General information

NPI: 1063250132
Provider Name (Legal Business Name): UNCHARTED THERAPEUTIC SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2075 CENTRAL AVE STE D
BILLINGS MT
59102-4956
US

IV. Provider business mailing address

PO BOX 80152
BILLINGS MT
59108-0152
US

V. Phone/Fax

Practice location:
  • Phone: 406-876-3096
  • Fax:
Mailing address:
  • Phone: 406-661-1558
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: KAYLA NEWTON
Title or Position: CLINICAL DIRECTOR
Credential: LSCW
Phone: 406-661-1558