Healthcare Provider Details

I. General information

NPI: 1609390509
Provider Name (Legal Business Name): ROCKY MOUNTAIN COUNSELING AND MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2017
Last Update Date: 02/17/2021
Certification Date: 02/16/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 HAGGERTY LN STE 13
BOZEMAN MT
59715-1780
US

IV. Provider business mailing address

280 W KAGY BLVD STE D328
BOZEMAN MT
59715-6056
US

V. Phone/Fax

Practice location:
  • Phone: 406-763-1183
  • Fax:
Mailing address:
  • Phone: 406-599-0183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHELLIE NEWMAN-NOON
Title or Position: MANAGER
Credential:
Phone: 406-763-1183