Provider Demographics
NPI:1457301798
Name:BAKKO, ROBERT G (LCPC)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:G
Last Name:BAKKO
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1643 LEWIS AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4151
Mailing Address - Country:US
Mailing Address - Phone:406-860-2233
Mailing Address - Fax:
Practice Address - Street 1:1643 LEWIS AVE STE 7
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-4151
Practice Address - Country:US
Practice Address - Phone:406-860-2233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT17101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0252756Medicaid