Healthcare Provider Details

I. General information

NPI: 1265238927
Provider Name (Legal Business Name): MICHAEL DALE YEGERLEHNER LCPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 03/08/2025
Certification Date: 03/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 2ND ST N
GREAT FALLS MT
59401-2412
US

IV. Provider business mailing address

313 2ND ST N
GREAT FALLS MT
59401-2412
US

V. Phone/Fax

Practice location:
  • Phone: 573-822-6171
  • Fax:
Mailing address:
  • Phone: 573-822-6171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-60333
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-PCLC-LIC-48307
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: