Healthcare Provider Details

I. General information

NPI: 1104775618
Provider Name (Legal Business Name): SHEDDING SKIN COUNSELING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2026
Last Update Date: 01/27/2026
Certification Date: 01/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6300 US HIGHWAY 93 S
WHITEFISH MT
59937-8235
US

IV. Provider business mailing address

6300 US HIGHWAY 93 S
WHITEFISH MT
59937-8235
US

V. Phone/Fax

Practice location:
  • Phone: 406-260-5516
  • Fax:
Mailing address:
  • Phone: 406-260-5516
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: TERRY LEE
Title or Position: OWNER
Credential: LAC, MSW, SWLC, CDVS
Phone: 406-260-5516