Provider Demographics
NPI:1720251101
Name:BUYSE, JASON LANE (LCSW)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:LANE
Last Name:BUYSE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 N BROADWAY
Mailing Address - Street 2:STE 603
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1255
Mailing Address - Country:US
Mailing Address - Phone:406-373-6911
Mailing Address - Fax:406-545-0205
Practice Address - Street 1:303 N BROADWAY
Practice Address - Street 2:SUITE 603
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1255
Practice Address - Country:US
Practice Address - Phone:406-256-6825
Practice Address - Fax:406-256-6836
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2017-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT818 LCSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker