Healthcare Provider Details

I. General information

NPI: 1124405816
Provider Name (Legal Business Name): COUNSELING ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2015
Last Update Date: 08/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 S EWING ST SUITE # 507
HELENA MT
59601-5938
US

IV. Provider business mailing address

PO BOX 7331
HELENA MT
59604-7331
US

V. Phone/Fax

Practice location:
  • Phone: 406-996-1034
  • Fax: 406-996-1034
Mailing address:
  • Phone: 406-996-1034
  • Fax: 406-996-1034

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: TRACY K VAUGHN
Title or Position: OWNER/THERAPIST
Credential: LCPC
Phone: 406-996-1034