Provider Demographics
NPI:1659077667
Name:CHARVET, AUSTIN PAUL (LCPC)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:PAUL
Last Name:CHARVET
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 1:126 E BROADWAY ST STE 5
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4565
Mailing Address - Country:US
Mailing Address - Phone:307-264-4664
Mailing Address - Fax:
Practice Address - Street 1:126 E BROADWAY ST STE 5
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4565
Practice Address - Country:US
Practice Address - Phone:406-298-3145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-01
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-71008101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty