Healthcare Provider Details

I. General information

NPI: 1568129914
Provider Name (Legal Business Name): RACHEL HARRIMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 07/16/2025
Certification Date: 07/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 6TH AVE SW
RONAN MT
59864-2600
US

IV. Provider business mailing address

1321 WYOMING ST
MISSOULA MT
59801-1725
US

V. Phone/Fax

Practice location:
  • Phone: 66-763-6004
  • Fax: 406-676-3738
Mailing address:
  • Phone: 406-532-8426
  • Fax: 406-224-4402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-51654
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: