Healthcare Provider Details

I. General information

NPI: 1740044635
Provider Name (Legal Business Name): DEMARCUS IGLEHART LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MARCUS IGLEHART

II. Dates (important events)

Enumeration Date: 02/12/2024
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2507 OTTAWA ST
BUTTE MT
59701-6207
US

IV. Provider business mailing address

2507 OTTAWA ST
BUTTE MT
59701-6207
US

V. Phone/Fax

Practice location:
  • Phone: 254-214-7555
  • Fax:
Mailing address:
  • Phone: 254-327-8996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC8154
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number76170
License Number StateMT
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number100301
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8171941
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: