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General NPI Number Information
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NPI Number | 1831736032
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Entity Type | Individual
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Provider Name | PHILLENE WHITEMAN LAC
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Gender | Female
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Dates
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Enumeration Date | 12/06/2019
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Last Update Date | 07/03/2025
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Provider Practice Location Address
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Address Line | 208 N BROADWAY STE 313
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City | BILLINGS
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State | MT
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Zip | 59101-1942
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Country | US
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Telephone | 406-861-6673
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Fax |
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Provider Business Mailing Address
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Address Line | 208 N BROADWAY STE 313946
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City | BILLINGS
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State | MT
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Zip | 59101-3988
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Country | US
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Telephone | 406-861-6673
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | BBHLACLIC32706
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | BBH-LAC-LIC-32706
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License Number State | MT
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