Provider Demographics
NPI:1093211674
Name:NEESE, DEBRA ANN (PCLC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:NEESE
Suffix:
Gender:F
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50625
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-0625
Mailing Address - Country:US
Mailing Address - Phone:406-690-4743
Mailing Address - Fax:406-534-2367
Practice Address - Street 1:1116 GRAND AVE STE 303
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4282
Practice Address - Country:US
Practice Address - Phone:406-690-4743
Practice Address - Fax:406-534-2367
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT30125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTBBH-PCLC-LIC-30125OtherBOARD OF BEHAVIORAL HEALTH