George Faegre

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

71040 Issued in MT

Practice address

105 W Main St Ste 2G
Bozeman, MT 59715-4689

Phone

(406) 384-5774

NPI assigned

Feb 2, 2023

Last updated

Jul 24, 2024By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1043916877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 982",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597710982",
            "telephone_number": "612-554-5409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W MAIN ST STE 2G",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597154689",
            "telephone_number": "406-384-5774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAEGRE",
        "first_name": "GEORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-02-02",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MT",
            "license": "71040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Bozeman, MT
• Providers in Bozeman, MT by specialty
• Mental Health Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.