Provider Demographics
NPI:1821077256
Name:BOUVIER, CHERYL JENAVIEVE (LCSW RPTS)
Entity Type:Individual
Prefix:MS
First Name:CHERYL
Middle Name:JENAVIEVE
Last Name:BOUVIER
Suffix:
Gender:F
Credentials:LCSW RPTS
Other - Prefix:
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Mailing Address - Street 1:516 FULLER AVE
Mailing Address - Street 2:STE. 1
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3301
Mailing Address - Country:US
Mailing Address - Phone:406-449-4800
Mailing Address - Fax:406-449-1393
Practice Address - Street 1:516 FULLER AVE
Practice Address - Street 2:STE. 2
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3301
Practice Address - Country:US
Practice Address - Phone:406-449-4800
Practice Address - Fax:406-449-1393
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2017-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MT3121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000502723Medicaid
MT0000502723Medicaid