Healthcare Provider Details

I. General information

NPI: 1619940160
Provider Name (Legal Business Name): SANDI ASHLEY LCPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 BROADWAY
HELENA MT
59601
US

IV. Provider business mailing address

304 BROADWAY
HELENA MT
59601
US

V. Phone/Fax

Practice location:
  • Phone: 406-449-3210
  • Fax: 406-495-8765
Mailing address:
  • Phone: 406-449-3210
  • Fax: 406-495-8765

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLCPC113
License Number StateMT

VIII. Authorized Official

Name: MS. SANDI ANN ASHLEY
Title or Position: OWNER
Credential: EDS LCPC
Phone: 406-449-3210