Provider Demographics
NPI:1699845875
Name:BERSANTI, SHERRY LYNN (LCPC)
Entity Type:Individual
Prefix:
First Name:SHERRY
Middle Name:LYNN
Last Name:BERSANTI
Suffix:
Gender:F
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:PO BOX 3089
Mailing Address - Street 2:CENTER FOR MENTAL HEALTH
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-443-7151
Mailing Address - Fax:406-443-3420
Practice Address - Street 1:900 JACKSON ST
Practice Address - Street 2:CENTER FOR MENTAL HEALTH
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3428
Practice Address - Country:US
Practice Address - Phone:406-443-7151
Practice Address - Fax:406-443-3420
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2014-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1091101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000750000OtherBLUE CROSS-SHIELD OF MONTANA CENTER FOR MENTAL HEALTH
MT741380OtherBCBS
MT0256126Medicaid