Provider Demographics
NPI:1912653718
Name:PERFITT, REBECKA L
Entity Type:Individual
Prefix:
First Name:REBECKA
Middle Name:L
Last Name:PERFITT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7604 MONAD RD
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-2608
Mailing Address - Country:US
Mailing Address - Phone:406-690-2906
Mailing Address - Fax:
Practice Address - Street 1:100 N 27TH ST STE 230
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-2054
Practice Address - Country:US
Practice Address - Phone:140-669-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-01
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT171400000X, 251S00000X
174400000X, 175T00000X
MTBBHBHPSCRT50477405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty
No174400000XOther Service ProvidersSpecialist
No175T00000XOther Service ProvidersPeer Specialist
No405300000XOther Service ProvidersPrevention Professional