Healthcare Provider Details

I. General information

NPI: 1396652095
Provider Name (Legal Business Name): RACHAEL WEGNER P-CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 GREAT NORTHERN BLVD
HELENA MT
59601-3340
US

IV. Provider business mailing address

203 BIRCH CT
COLSTRIP MT
59323-9656
US

V. Phone/Fax

Practice location:
  • Phone: 406-936-3593
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-PCLC-LIC-80965
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: