Chief Holystar Fish, COUNSELOR

Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Browning, MT

NPI 1982391744 · NPPES record last updated Apr 21, 2023

Key facts

NPI
1982391744
Entity type
Individual (NPI type 1)
Primary specialty
Addiction (Substance Use Disorder) Counselor 101YA0400X
License
BBH-ACLC-LIC-57162 (MT)
Practice address
807 N Piegan St
Browning, MT 59417-5217
Phone
(406) 338-6330
NPI assigned
Apr 21, 2023
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
BBH-ACLC-LIC-57162MTMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Crystal Creek Lodge Current
since Apr 23, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X BBH-ACLC-LIC-57162 MT Yes

Addresses

Primary practice location

807 N Piegan St
Browning, MT 59417-5217

Mailing address

PO Box 450
Browning, MT 59417-0450
Phone (406) 338-6330

Other providers in Browning, MT

All providers in Browning, MT · Addiction (Substance Use Disorder) Counselor in Montana

Sources for this page

Verify at the official NPI Registry.