MEDICARE: CHEYANNE NICHOLE CARL PCLC

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	101YM0800X	Mental Health Counselor	BBH-PCLC-LIC-88869	MT

General Provider Information

NPI Number	:	1235060625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHEYANNE NICHOLE CARL PCLC

Provider Business Mailing Address
First Line	:	3333 2ND AVE N STE 160
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59101-2060
Country	:	US
Telephone Number	:	406-213-3313
Fax Number	:	406-296-5282

Provider Business Practice Location Address
First Line	:	3333 2ND AVE N STE 160
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59101-2060
Country	:	US
Telephone Number	:	406-213-3313
Fax Number	:	406-296-5282

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

Provider Enumeration Date	:	05/26/2026
Last Update Date	:	05/26/2026

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