Provider Demographics
NPI:1972188043
Name:FOLEY, CHRISTIAN (LAC)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:FOLEY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:CHRISTIAN
Other - Middle Name:
Other - Last Name:FOLEY-HAIGHT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:471 E MERCURY ST
Mailing Address - Street 2:
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1906
Mailing Address - Country:US
Mailing Address - Phone:406-496-1172
Mailing Address - Fax:406-782-6964
Practice Address - Street 1:630 W MERCURY ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1510
Practice Address - Country:US
Practice Address - Phone:406-299-3448
Practice Address - Fax:406-299-3450
Is Sole Proprietor?:No
Enumeration Date:2021-03-10
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBHLACLIC4928101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)