Organization
PINE RIDGE COUNSELING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASON L BUYSE LCSW (SOLE MEMBER)
(406) 252-1177
Entity
Organization
Contact information
Practice address
4530 BROOKHAVEN PL, BILLINGS, MT 59105-4939
(406) 252-1177
Mailing address
4530 BROOKHAVEN PL, BILLINGS, MT 59105-4939
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
818-LCSW
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720251101
NPI
MT
Enumeration date
10/28/2010
Last updated
10/28/2010
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