Provider Demographics
NPI:1750754321
Name:HORIGAN, JAIME (LCPC, LAC)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:
Last Name:HORIGAN
Suffix:
Gender:F
Credentials:LCPC, LAC
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:
Other - Last Name:GOLLIHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:2078 STADIUM DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-7204
Mailing Address - Country:US
Mailing Address - Phone:406-414-7711
Mailing Address - Fax:406-414-7713
Practice Address - Street 1:2078 STADIUM DR STE 103
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-7204
Practice Address - Country:US
Practice Address - Phone:406-414-7711
Practice Address - Fax:406-414-7713
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-04
Last Update Date:2019-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLAC-LIC-3632101YA0400X
MTLCPC-LIC-39051101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)