Provider Demographics
NPI:1104020403
Name:YELLOWSTONE COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:YELLOWSTONE COUNSELING CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHRISTY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-896-8427
Mailing Address - Street 1:208 N 28TH ST
Mailing Address - Street 2:SUITE 423
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1937
Mailing Address - Country:US
Mailing Address - Phone:406-896-8427
Mailing Address - Fax:406-245-5980
Practice Address - Street 1:208 N 28TH ST
Practice Address - Street 2:SUITE 423
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1937
Practice Address - Country:US
Practice Address - Phone:406-896-8427
Practice Address - Fax:406-245-5980
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2010-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT454101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty