Healthcare Provider Details

I. General information

NPI: 1215412903
Provider Name (Legal Business Name): SARAH PENCE BBH-LCPC-LIC-75632
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 12/31/2025
Certification Date: 12/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 3RD AVE E
KALISPELL MT
59901-5780
US

IV. Provider business mailing address

163 TAYLOR RD
WHITEFISH MT
59937-8419
US

V. Phone/Fax

Practice location:
  • Phone: 406-607-4900
  • Fax:
Mailing address:
  • Phone: 360-551-7116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberCP60959914
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-LCPC-LIC-75632
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61556179
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: