Jeanie Bohall, LCPC

Individual provider Active NPI Marriage & Family Therapist · Great Falls, MT

NPI 1740925403 · NPPES record last updated Dec 27, 2022

Key facts

NPI
1740925403
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
56559 (MT)
Practice address
2720 10TH Ave S
Great Falls, MT 59405-3240
Phone
(067) 314-8888
Fax
(406) 731-8318
NPI assigned
Apr 27, 2022
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
83698TXMDCounselor
56559MTMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor
Group: 193400000X SINGLE SPECIALTY GROUP
101Y00000X 83698 TX
Professional Counselor 101YP2500X 56559 MT
Marriage & Family Therapist 106H00000X 56559 MT Yes

Addresses

Primary practice location

2720 10TH Ave S
Great Falls, MT 59405-3240

Mailing address

2720 10TH Ave S
Great Falls, MT 59405-3240
Phone (067) 314-8888

Other providers in Great Falls, MT

All providers in Great Falls, MT · Marriage & Family Therapist in Montana

Sources for this page

Verify at the official NPI Registry.