Provider Demographics
NPI:1841989621
Name:SCHUSTER, DENNIS GARY JR (PCLC)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:GARY
Last Name:SCHUSTER
Suffix:JR
Gender:M
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 KERI CT
Mailing Address - Street 2:
Mailing Address - City:ALBERTON
Mailing Address - State:MT
Mailing Address - Zip Code:59820-8510
Mailing Address - Country:US
Mailing Address - Phone:406-396-9505
Mailing Address - Fax:
Practice Address - Street 1:16862 BECKWITH ST STE S
Practice Address - Street 2:
Practice Address - City:FRENCHTOWN
Practice Address - State:MT
Practice Address - Zip Code:59834-9001
Practice Address - Country:US
Practice Address - Phone:406-396-9505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-56904101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health