Organization
BRAVE ROOTS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAELA IMM MSW, LCSW (OWNER)
(406) 272-2532
Entity
Organization
Contact information
Practice address
944 AVENUE B, BILLINGS, MT 59102-3346
(406) 272-2532
Mailing address
PO BOX 22214, BILLINGS, MT 59104-2214
(406) 272-2532
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679169585
—
MT
Enumeration date
01/13/2021
Last updated
01/13/2021
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