Healthcare Provider Details

I. General information

NPI: 1386383446
Provider Name (Legal Business Name): JOANNA WRIGHT COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2022
Last Update Date: 05/27/2022
Certification Date: 05/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2135 CHARLOTTE ST STE 1A
BOZEMAN MT
59718-2741
US

IV. Provider business mailing address

914 W BABCOCK ST
BOZEMAN MT
59715-5440
US

V. Phone/Fax

Practice location:
  • Phone: 406-640-6264
  • Fax:
Mailing address:
  • Phone: 352-328-4770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOANNA WRIGHT
Title or Position: COUNSELOR
Credential: LCPC
Phone: 406-640-6264