Provider Demographics
NPI:1053183962
Name:ROCKY MOUNTAIN COUNSELING CENTER LLC
Entity type:Organization
Organization Name:ROCKY MOUNTAIN COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:G
Authorized Official - Last Name:BEARD
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-303-0031
Mailing Address - Street 1:619 SW HIGGINS AVE STE K
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1430
Mailing Address - Country:US
Mailing Address - Phone:406-303-0031
Mailing Address - Fax:
Practice Address - Street 1:619 SW HIGGINS AVE STE K
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1430
Practice Address - Country:US
Practice Address - Phone:406-303-0031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty