Provider Demographics
NPI:1255971321
Name:HENSEN, BLAIR (LCPC)
Entity type:Individual
Prefix:MS
First Name:BLAIR
Middle Name:
Last Name:HENSEN
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 1:1104 E MAIN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3884
Mailing Address - Country:US
Mailing Address - Phone:406-233-1336
Mailing Address - Fax:
Practice Address - Street 1:1104 E MAIN ST STE 4
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3884
Practice Address - Country:US
Practice Address - Phone:406-233-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-07
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT41966101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health