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General NPI Number Information
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NPI Number | 1477093854
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Entity Type | Individual
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Provider Name | BECKA RAE EIDE M.ED., LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/03/2017
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Last Update Date | 03/06/2017
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Provider Practice Location Address
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Address Line | 1732 S 72ND ST W
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City | BILLINGS
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State | MT
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Zip | 59106-3538
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Country | US
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Telephone | 406-651-2814
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Fax |
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Provider Business Mailing Address
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Address Line | 1732 S 72ND ST W
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City | BILLINGS
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State | MT
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Zip | 59106-3538
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Country | US
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Telephone | 406-651-2814
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | BBH-LCPC-LIC-23177
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | SWP-LCPC-LIC-11538
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License Number State | MT
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