Bonita Hagbom, ACLC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ulm, MT
NPI 1346983244 · NPPES record last updated Oct 1, 2024
Key facts
- NPI
- 1346983244
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- BBH-ACLC-LIC-71887 (MT)
- Practice address
- PO Box 295
Ulm, MT 59485-0295 - Phone
- (000) 000-0000
- NPI assigned
- Apr 18, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BBH-ACLC-LIC-71887 | MT | MD | Addiction (Substance Use Disorder) Counselor |
| CO61295697 | WA | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CO61295697 | WA | |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | BBH-ACLC-LIC-71887 | MT | Yes |
Addresses
Primary practice location
PO Box 295
Ulm, MT 59485-0295
Mailing address
PO Box 295
Ulm, MT 59485-0295
Other providers in Ulm, MT
All providers in Ulm, MT · Addiction (Substance Use Disorder) Counselor in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.