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General NPI Number Information
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NPI Number | 1417743709
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Entity Type | Organization
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Legal Business Name | MCH COUNSELING
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Dates
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Enumeration Date | 04/15/2025
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 107 E 1ST ST
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City | GILLETTE
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State | WY
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Zip | 82716-3801
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Country | US
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Telephone | 307-228-4622
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Fax |
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Provider Business Mailing Address
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Address Line | 102 TEAK ST
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City | GILLETTE
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State | WY
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Zip | 82718-6313
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Country | US
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Telephone | 605-484-0489
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH CLINICIAN
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Name | MARIE CHRISTINE HOVDEN HEATH
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Credential | MS, LPC
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Telephone | 605-484-0489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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