Healthcare Provider Details

I. General information

NPI: 1649339094
Provider Name (Legal Business Name): SEWELL CONSULTING CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2139 BROADWATER AVE
BILLINGS MT
59102-4761
US

IV. Provider business mailing address

2139 BROADWATER AVE
BILLINGS MT
59102-4761
US

V. Phone/Fax

Practice location:
  • Phone: 406-652-7752
  • Fax:
Mailing address:
  • Phone: 406-652-7752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number390
License Number StateMT

VIII. Authorized Official

Name: MR. MARC SEWELL
Title or Position: OWNER
Credential: LCPC
Phone: 406-652-7752