Provider Demographics
NPI:1295077311
Name:YELLOWSTONE VALLEY BEHAVIORAL HEALTH, PC
Entity type:Organization
Organization Name:YELLOWSTONE VALLEY BEHAVIORAL HEALTH, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:BURROWS
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-969-2273
Mailing Address - Street 1:490 N 31ST ST STE 110
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1256
Mailing Address - Country:US
Mailing Address - Phone:406-969-2273
Mailing Address - Fax:855-823-3242
Practice Address - Street 1:490 N 31ST ST STE 110
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1256
Practice Address - Country:US
Practice Address - Phone:406-969-2273
Practice Address - Fax:855-823-3242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-27
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCSW-LIC-23291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty