Healthcare Provider Details

I. General information

NPI: 1801621966
Provider Name (Legal Business Name): BROOKE OLIVIA BEIGHLE MA, LCPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2024
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 KENSINGTON AVEUE SUITE 201
MISSOULA MT
59801
US

IV. Provider business mailing address

1401 CEDAR STREET UNIT 3
MISSOULA MT
59802
US

V. Phone/Fax

Practice location:
  • Phone: 406-220-6195
  • Fax: 406-662-7249
Mailing address:
  • Phone: 406-370-9728
  • Fax: 406-662-7249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-90090
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: