Provider Demographics
NPI:1104631613
Name:BIERLE, SANDRA L (MS, LCPC)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:L
Last Name:BIERLE
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 HAGGERTY LN STE 275
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-8805
Mailing Address - Country:US
Mailing Address - Phone:605-359-6852
Mailing Address - Fax:
Practice Address - Street 1:205 HAGGERTY LN STE 275
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8805
Practice Address - Country:US
Practice Address - Phone:406-551-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT78663101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health