Healthcare Provider Details
I. General information
NPI: 1912611591
Provider Name (Legal Business Name): MOXY COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/09/2023
Last Update Date: 01/09/2023
Certification Date: 01/09/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
404 N 31ST ST STE 421
BILLINGS MT
59101-1211
US
IV. Provider business mailing address
6049 MOLLIE ROSE LN
BILLINGS MT
59101-6495
US
V. Phone/Fax
- Phone: 406-272-7098
- Fax:
- Phone: 320-583-5906
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
ASHLEY
NOVAKOVICH
Title or Position: OWNER
Credential: LCSW
Phone: 406-272-7098