Provider Demographics
NPI:1376722199
Name:GREAT FALLS COUNSELING
Entity Type:Organization
Organization Name:GREAT FALLS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BOTTOMLY
Authorized Official - Suffix:
Authorized Official - Credentials:LCPCSOTS
Authorized Official - Phone:406-771-8713
Mailing Address - Street 1:PO BOX 6810
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59406-6810
Mailing Address - Country:US
Mailing Address - Phone:406-771-8713
Mailing Address - Fax:406-771-4736
Practice Address - Street 1:926 13TH AVE S
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-4406
Practice Address - Country:US
Practice Address - Phone:406-771-8713
Practice Address - Fax:406-771-4736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT585LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0254033Medicaid
MT000074535OtherBLUE CROSS