Provider Demographics
NPI:1821583527
Name:SPEICHER, SIENNA CHEYENNE (LCPC)
Entity Type:Individual
Prefix:
First Name:SIENNA
Middle Name:CHEYENNE
Last Name:SPEICHER
Suffix:
Gender:F
Credentials:LCPC
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 943
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-0943
Mailing Address - Country:US
Mailing Address - Phone:406-239-8472
Mailing Address - Fax:
Practice Address - Street 1:504 SE BOUNDARY ST
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417-5146
Practice Address - Country:US
Practice Address - Phone:406-239-8472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-30839101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional