Healthcare Provider Details

I. General information

NPI: 1598573818
Provider Name (Legal Business Name): ALYSSA RAE WIEBE LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALYSSA RAE DAWES LCPC

II. Dates (important events)

Enumeration Date: 12/19/2024
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 S 27TH ST
BILLINGS MT
59101-4227
US

IV. Provider business mailing address

123 S 27TH ST
BILLINGS MT
59101-4227
US

V. Phone/Fax

Practice location:
  • Phone: 406-247-3350
  • Fax: 406-247-3389
Mailing address:
  • Phone: 406-247-3350
  • Fax: 406-247-3389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number78990
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: