Provider Demographics
NPI:1760003750
Name:PHILLIPS, BARBARA ANNE (LAC (101YA0400X))
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNE
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:LAC (101YA0400X)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-0147
Mailing Address - Country:US
Mailing Address - Phone:406-248-3175
Mailing Address - Fax:
Practice Address - Street 1:1231 N 29TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0147
Practice Address - Country:US
Practice Address - Phone:406-248-3175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-30
Last Update Date:2020-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)