Healthcare Provider Details

I. General information

NPI: 1568386316
Provider Name (Legal Business Name): JOSE CRISTIAN REYES MORTERO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1750 RAY OF HOPE LN
BILLINGS MT
59106-3502
US

IV. Provider business mailing address

635 N 26TH ST
BILLINGS MT
59101-1055
US

V. Phone/Fax

Practice location:
  • Phone: 406-651-2971
  • Fax: 406-651-2802
Mailing address:
  • Phone: 573-714-6485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberBBHSWLCLIC90253
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: