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General NPI Number Information
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NPI Number | 1609676824
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Entity Type | Organization
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Legal Business Name | PHOENIX COUNSELING
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 2023 STADIUM DR # 1C-103
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City | BOZEMAN
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State | MT
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Zip | 59715-0613
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Country | US
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Telephone | 406-404-6660
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Fax |
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Provider Business Mailing Address
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Address Line | 1191 LONGBOW LN APT E
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City | BOZEMAN
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State | MT
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Zip | 59718-6683
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Country | US
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Telephone | 406-939-4211
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AMANDA LYNN KUEHN
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Credential | MS, LCPC
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Telephone | 406-939-4211
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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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