Healthcare Provider Details

I. General information

NPI: 1588580732
Provider Name (Legal Business Name): RYAN RECTOR SWLC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1523 E BROADWAY ST
HELENA MT
59601-5234
US

IV. Provider business mailing address

1523 E BROADWAY ST
HELENA MT
59601-5234
US

V. Phone/Fax

Practice location:
  • Phone: 925-813-5188
  • Fax:
Mailing address:
  • Phone: 925-813-5188
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-SWLC-LIC-88954
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: