MEDICARE: BRANDI K BUCKLES LCPC, CRC

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-LCPC-LIC-57245	MT
2	163W00000X	Registered Nurse	NUR-RN-LIC-267890	MT

General Provider Information

NPI Number	:	1972110773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI K BUCKLES LCPC, CRC

Provider Business Mailing Address
First Line	:	2113 INTERLACHEN DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-3648
Country	:	US
Telephone Number	:	406-208-8005
Fax Number	:

Provider Business Practice Location Address
First Line	:	2113 INTERLACHEN DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59105-3648
Country	:	US
Telephone Number	:	406-272-3616
Fax Number	:

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

Provider Enumeration Date	:	09/25/2020
Last Update Date	:	01/20/2026

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