Provider Demographics
NPI:1497640866
Name:ROBERTSON, RACHEL (PCLC)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:PCLC
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 4734
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59772-4734
Mailing Address - Country:US
Mailing Address - Phone:406-595-3746
Mailing Address - Fax:406-578-1363
Practice Address - Street 1:1924 W STEVENS ST STE 202
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59718-7043
Practice Address - Country:US
Practice Address - Phone:406-595-3746
Practice Address - Fax:406-578-1363
Is Sole Proprietor?:No
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-70486101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health