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General NPI Number Information
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NPI Number | 1902693054
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Entity Type | Organization
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Legal Business Name | BLUE MOUNTAIN COUNSELING
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 129 W PARK ST
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City | BUTTE
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State | MT
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Zip | 59701-1719
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Country | US
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Telephone | 406-531-2350
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Fax |
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Provider Business Mailing Address
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Address Line | 1331 STEELE ST
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City | BUTTE
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State | MT
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Zip | 59701-2139
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Country | US
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Telephone | 406-531-2350
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RAENELLE RICHARDSON
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Credential | LCPC
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Telephone | 406-531-2350
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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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