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General NPI Number Information
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NPI Number | 1578360921
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Entity Type | Organization
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Legal Business Name | NORTHERN SUN THERAPY & WELLNESS LLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 65 W KAGY BLVD STE A
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City | BOZEMAN
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State | MT
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Zip | 59715-6052
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Country | US
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Telephone | 406-548-4012
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Fax | 406-451-0051
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Provider Business Mailing Address
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Address Line | 65 W KAGY BLVD STE A
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City | BOZEMAN
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State | MT
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Zip | 59715-6052
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Country | US
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Telephone | 406-548-4012
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Fax | 406-451-0051
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Authorized Official
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Title or Position | MANAGER
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Name | REBECCA STOKES
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Credential | LCPC
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Telephone | 406-548-4012
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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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