Provider Demographics
NPI:1073249322
Name:AUGARE, SHANNON JAMES (MS, LCPC, NCC)
Entity Type:Individual
Prefix:MR
First Name:SHANNON
Middle Name:JAMES
Last Name:AUGARE
Suffix:
Gender:M
Credentials:MS, LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2031
Mailing Address - Street 2:
Mailing Address - City:BROWNING
Mailing Address - State:MT
Mailing Address - Zip Code:59417-2031
Mailing Address - Country:US
Mailing Address - Phone:406-845-8241
Mailing Address - Fax:
Practice Address - Street 1:38 BAD EYES ROAD
Practice Address - Street 2:
Practice Address - City:BROWNING
Practice Address - State:MT
Practice Address - Zip Code:59417-2031
Practice Address - Country:US
Practice Address - Phone:406-845-8241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-28
Last Update Date:2023-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-64522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional