Provider Demographics
NPI:1649165143
Name:DENNIS, MICHELE M (CBHPPS)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:DENNIS
Suffix:
Gender:F
Credentials:CBHPPS
Other - Prefix:
Other - First Name:MICHELE
Other - Middle Name:M
Other - Last Name:DENNIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CBHPPS
Mailing Address - Street 1:2656 S MONTANA ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-3120
Mailing Address - Country:US
Mailing Address - Phone:406-564-2364
Mailing Address - Fax:
Practice Address - Street 1:27 WEST PARK STREET
Practice Address - Street 2:#2 (PARK STREET MINI MALL)
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-3120
Practice Address - Country:US
Practice Address - Phone:406-564-2364
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-BHPS-CRT-76202175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist