Healthcare Provider Details

I. General information

NPI: 1104342880
Provider Name (Legal Business Name): BLANCHE NICOLE SUMNER MS, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 05/11/2026
Certification Date: 05/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 COLONIAL DR
HELENA MT
59601-4926
US

IV. Provider business mailing address

2755 COLONIAL DR
HELENA MT
59601-4926
US

V. Phone/Fax

Practice location:
  • Phone: 406-444-7500
  • Fax:
Mailing address:
  • Phone: 406-444-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number55464
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: