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General NPI Number Information
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NPI Number | 1962217166
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Entity Type | Organization
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Legal Business Name | 1111 NEW BEGINNINGS
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Dates
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Enumeration Date | 02/12/2025
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 2139 BROADWATER AVE STE F
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City | BILLINGS
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State | MT
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Zip | 59102-4761
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Country | US
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Telephone | 406-208-5264
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Fax | 406-208-5264
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Provider Business Mailing Address
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Address Line | PO BOX 23704
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City | BILLINGS
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State | MT
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Zip | 59104-3704
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Country | US
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Telephone | 406-208-5264
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENDY MCCOY
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Credential | LCPC, LAC
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Telephone | 406-208-5264
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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 |
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License Number State |
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Taxonomy #2
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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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