Healthcare Provider Details

I. General information

NPI: 1154083681
Provider Name (Legal Business Name): HEIDI WHYTE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 10/01/2025
Certification Date: 10/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

693 STOCKETT RD STE A
SAND COULEE MT
59472-9757
US

IV. Provider business mailing address

601 1ST AVE N
GREAT FALLS MT
59401-2510
US

V. Phone/Fax

Practice location:
  • Phone: 406-454-6973
  • Fax: 406-791-9277
Mailing address:
  • Phone: 406-454-6973
  • Fax: 406-791-9277

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-LCSW-LIC-50611
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: