Healthcare Provider Details

I. General information

NPI: 1780549501
Provider Name (Legal Business Name): ALECIA LEONETTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2025
Last Update Date: 12/24/2025
Certification Date: 12/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

563 E EVERGREEN DR
KALISPELL MT
59901-2416
US

IV. Provider business mailing address

563 E EVERGREEN DR
KALISPELL MT
59901-2416
US

V. Phone/Fax

Practice location:
  • Phone: 406-897-4470
  • Fax: 406-897-4470
Mailing address:
  • Phone: 406-897-4470
  • Fax: 406-897-4470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberBHH-ACLC-LIC-85867
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: