Healthcare Provider Details

I. General information

NPI: 1649132341
Provider Name (Legal Business Name): AARON DEAN ARCHER LAC, PCLC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2025
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1860 US HIGHWAY 93 N
KALISPELL MT
59901-2627
US

IV. Provider business mailing address

108 OWENS CT
KALISPELL MT
59901-1203
US

V. Phone/Fax

Practice location:
  • Phone: 406-309-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBBH-LAC-LIC-80228
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: