Individual
MRS. CHERYL A. BASTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC 57404; LAC 1290
Contact information
Practice address
1301 12TH AVE S STE 103, GREAT FALLS, MT 59405-4600
(406) 836-2714
(888) 624-2676
Mailing address
PO BOX 6025, GREAT FALLS, MT 59406-6025
(406) 836-2714
(888) 624-2676
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
57404
MT
101YA0400X
Addiction (Substance Use Disorder) Counselor
1290
MT
101YP2500X
Professional Counselor
Primary
57404
MT
101YP2500X
Professional Counselor
57404
—
Other
Enumeration date
02/06/2009
Last updated
01/17/2023
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