Provider Demographics
NPI:1386359016
Name:BIG SKY PSYCHOLOGICAL COACHING LLC
Entity type:Organization
Organization Name:BIG SKY PSYCHOLOGICAL COACHING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:WIEGERT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:406-662-8802
Mailing Address - Street 1:4315 PALISADES PARK DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-1344
Mailing Address - Country:US
Mailing Address - Phone:540-287-6161
Mailing Address - Fax:
Practice Address - Street 1:1643 24TH ST W STE 103
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2677
Practice Address - Country:US
Practice Address - Phone:406-662-8802
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health