Provider Demographics
NPI:1760229165
Name:BURNS, JENAYA (NCC, PCLC)
Entity type:Individual
Prefix:
First Name:JENAYA
Middle Name:
Last Name:BURNS
Suffix:
Gender:F
Credentials:NCC, PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41701 JOE DOG DR
Mailing Address - Street 2:
Mailing Address - City:RONAN
Mailing Address - State:MT
Mailing Address - Zip Code:59864-8639
Mailing Address - Country:US
Mailing Address - Phone:406-274-1258
Mailing Address - Fax:
Practice Address - Street 1:330 MAIN ST SW
Practice Address - Street 2:
Practice Address - City:RONAN
Practice Address - State:MT
Practice Address - Zip Code:59864-2707
Practice Address - Country:US
Practice Address - Phone:406-676-0630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-11
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-ACLC-LIC-72217101YA0400X
MTBBH-PCLC-LIC-72188101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)