| Bitterroot Behavioral Health Llc | |
|
320 N 1st St Ste G Hamilton MT 59840-2569 | |
| (406) 662-1050 | |
| Not Available |
| Full Name | Bitterroot Behavioral Health Llc |
|---|---|
| Speciality | Social Worker |
| Location | 320 N 1st St Ste G, Hamilton, Montana |
| Authorized Official Name and Position | Blythe Siebenaller (OWNER) |
| Authorized Official Contact | 4066621050 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bitterroot Behavioral Health Llc 320 N 1st St Ste G Hamilton MT 59840-2569 Ph: (406) 662-1050 | Bitterroot Behavioral Health Llc 320 N 1st St Ste G Hamilton MT 59840-2569 Ph: (406) 662-1050 |
| NPI Number | 1639923691 |
|---|---|
| Provider Enumeration Date | 04/16/2024 |
| Last Update Date | 04/16/2024 |
| Certification Date | 04/16/2024 |
| Medicare PECOS PAC ID | 1557702594 |
|---|---|
| Medicare Enrollment ID | O20240614001737 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639923691 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Blythe Erin Siebenaller |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1821440223 PECOS PAC ID: 0547668022 Enrollment ID: I20211014000005 |
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