Provider Demographics
NPI:1487245452
Name:SPANISH PEAKS MENTAL HEALTH, PLLC
Entity type:Organization
Organization Name:SPANISH PEAKS MENTAL HEALTH, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:PRISCU
Authorized Official - Suffix:
Authorized Official - Credentials:JD, LCPC
Authorized Official - Phone:406-282-4495
Mailing Address - Street 1:PO BOX 392
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80544-0392
Mailing Address - Country:US
Mailing Address - Phone:406-570-6751
Mailing Address - Fax:
Practice Address - Street 1:8353 SADDLE MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-8789
Practice Address - Country:US
Practice Address - Phone:406-282-4495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-01
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty