MEDICARE: HAILEY O'BRIEN LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	BBH-LCPC-LIC-72775	MT
2	101YM0800X	Mental Health Counselor	72775	MT

General Provider Information

NPI Number	:	1124838073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAILEY O'BRIEN LCPC

Provider Business Mailing Address
First Line	:	205 E PARK AVE
Second Line	:
City	:	ANACONDA
State	:	MT
Zip	:	59711-2340
Country	:	US
Telephone Number	:	406-563-8117
Fax Number	:

Provider Business Practice Location Address
First Line	:	205 E PARK AVE
Second Line	:
City	:	ANACONDA
State	:	MT
Zip	:	59711-2340
Country	:	US
Telephone Number	:	406-563-8117
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2025
Last Update Date	:	03/03/2026

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Directions to “ HAILEY O'BRIEN LCPC” Practice Location

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