Healthcare Provider Details

I. General information

NPI: 1902784176
Provider Name (Legal Business Name): ROWAN REDFIELD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2025
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

65 COMMONS WAY
KALISPELL MT
59901-1908
US

IV. Provider business mailing address

65 COMMONS WAY
KALISPELL MT
59901-1908
US

V. Phone/Fax

Practice location:
  • Phone: 406-393-8083
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-PCLC-LIC-89371
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: