Healthcare Provider Details

I. General information

NPI: 1043887771
Provider Name (Legal Business Name): STACEY LINKE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2021
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2615 COLONIAL DR
HELENA MT
59601-4910
US

IV. Provider business mailing address

2615 COLONIAL DR
HELENA MT
59601-4910
US

V. Phone/Fax

Practice location:
  • Phone: 406-422-4213
  • Fax:
Mailing address:
  • Phone: 406-422-4213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberTSLP-4777
License Number StateID
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberPRD-SP-LIC-11657
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: