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General NPI Number Information
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NPI Number | 1487245452
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Entity Type | Organization
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Legal Business Name | SPANISH PEAKS MENTAL HEALTH, PLLC
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 10/31/2024
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Provider Practice Location Address
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Address Line | 8353 SADDLE MOUNTAIN RD
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City | BOZEMAN
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State | MT
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Zip | 59715-8789
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Country | US
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Telephone | 406-282-4495
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 392
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City | NIWOT
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State | CO
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Zip | 80544-0392
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Country | US
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Telephone | 406-570-6751
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | HOLLY PRISCU
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Credential | JD, LCPC
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Telephone | 406-282-4495
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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