Provider Demographics
NPI:1093381162
Name:STREDWICK, BILLIE JO (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:BILLIE
Middle Name:JO
Last Name:STREDWICK
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:BILLIE
Other - Middle Name:JO
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:701 W RIVER ROCK RD
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-9547
Mailing Address - Country:US
Mailing Address - Phone:406-599-2088
Mailing Address - Fax:
Practice Address - Street 1:2040 N 22ND AVE STE 2
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-3152
Practice Address - Country:US
Practice Address - Phone:406-586-5511
Practice Address - Fax:406-586-4713
Is Sole Proprietor?:No
Enumeration Date:2021-05-31
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-RED-45953101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional