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Organization
WHITEPINE COUNSELING SERVICES P C
Active
Organization
WHITEPINE COUNSELING SERVICES P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SALLY LARSON BABCOCK MED, LCPC (PRESIDENT)
(406) 586-8030
Entity
Organization
Contact information
Practice address
104 E MAIN ST, STE 302, BOZEMAN, MT 59715-4760
(406) 586-8038
Mailing address
104 E MAIN ST, STE 302, BOZEMAN, MT 59715-4760
(406) 586-8038
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
451
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0000255051
—
MT
01
—
BCBS #07527-3
BLUE CROSS BLUE SHIELD
MT
Enumeration date
12/19/2006
Last updated
08/22/2020
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