Healthcare Provider Details

I. General information

NPI: 1942121769
Provider Name (Legal Business Name): MOUNTAIN ROOTS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2026
Last Update Date: 07/25/2026
Certification Date: 07/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 AVENUE D STE A10
BILLINGS MT
59102-3042
US

IV. Provider business mailing address

1629 AVENUE D STE A10
BILLINGS MT
59102-3042
US

V. Phone/Fax

Practice location:
  • Phone: 406-672-0802
  • Fax:
Mailing address:
  • Phone: 406-672-0802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: NAOMI NATION
Title or Position: PROVIDER / OWNER
Credential:
Phone: 406-672-0802