Provider Demographics
NPI:1306697594
Name:REICHMAN, KRYSTI (PCLC)
Entity type:Individual
Prefix:
First Name:KRYSTI
Middle Name:
Last Name:REICHMAN
Suffix:
Gender:F
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 BUCHANAN ST SW
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-2615
Mailing Address - Country:US
Mailing Address - Phone:406-309-0082
Mailing Address - Fax:
Practice Address - Street 1:11 MAIN ST SE
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-2731
Practice Address - Country:US
Practice Address - Phone:406-872-0630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-27
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-70450101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional