| Deep Roots Counseling | |
|
1720 Four Mile Rd Butte MT 59701-0907 | |
| (406) 299-3768 | |
| Not Available |
| Full Name | Deep Roots Counseling |
|---|---|
| Speciality | Clinic/Center |
| Location | 1720 Four Mile Rd, Butte, Montana |
| Authorized Official Name and Position | Bernadette Reynolds (PRESIDENT) |
| Authorized Official Contact | 4064984086 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Deep Roots Counseling 1720 Four Mile Rd Butte MT 59701-0907 Ph: (406) 299-3768 | Deep Roots Counseling 1720 Four Mile Rd Butte MT 59701-0907 Ph: (406) 299-3768 |
| NPI Number | 1528765088 |
|---|---|
| Provider Enumeration Date | 02/14/2023 |
| Last Update Date | 07/01/2024 |
| Certification Date | 07/01/2024 |
| Medicare PECOS PAC ID | 8921467614 |
|---|---|
| Medicare Enrollment ID | O20230628002788 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528765088 | NPI | - | NPPES |
| Provider Name | Alicia L Foley |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487155370 PECOS PAC ID: 4183986466 Enrollment ID: I20180326002835 |
| Provider Name | Rachelle Pryor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952027864 PECOS PAC ID: 0446628762 Enrollment ID: I20221117001882 |
| Provider Name | Hailie Nicole Maas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356020168 PECOS PAC ID: 7618315219 Enrollment ID: I20240402001344 |
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