Provider Demographics
NPI:1366186348
Name:JANSMA, PHYLLIS L (PCLC, LAC)
Entity type:Individual
Prefix:MS
First Name:PHYLLIS
Middle Name:L
Last Name:JANSMA
Suffix:
Gender:F
Credentials:PCLC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7830 COAKLEY RD
Mailing Address - Street 2:
Mailing Address - City:ACTON
Mailing Address - State:MT
Mailing Address - Zip Code:59002-2102
Mailing Address - Country:US
Mailing Address - Phone:406-298-0979
Mailing Address - Fax:
Practice Address - Street 1:1231 N 29TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-0147
Practice Address - Country:US
Practice Address - Phone:406-248-3175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT30312101YA0400X
MT62894101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)