Healthcare Provider Details

I. General information

NPI: 1710415682
Provider Name (Legal Business Name): CHELLIE NEWMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2017
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 W VILLARD ST UPPR LEVEL
BOZEMAN MT
59715-3532
US

IV. Provider business mailing address

113 W VILLARD ST UPPR LEVEL
BOZEMAN MT
59715-3532
US

V. Phone/Fax

Practice location:
  • Phone: 406-599-0183
  • Fax:
Mailing address:
  • Phone: 406-599-0183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number23895
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: