Healthcare Provider Details

I. General information

NPI: 1326784208
Provider Name (Legal Business Name): WILLIAM ROPER GREEN LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2022
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 TSCHACHE LN
BOZEMAN MT
59715-7965
US

IV. Provider business mailing address

1695 TSCHACHE LN
BOZEMAN MT
59715-7965
US

V. Phone/Fax

Practice location:
  • Phone: 406-585-1360
  • Fax:
Mailing address:
  • Phone: 406-585-1360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-LCPC-LIC-55777
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-55777
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberBBH-LCPC-LIC-55777
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: