Organization
BOZEMAN SUPPORTIVE COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MOLLY JO BASTA LCPC (LCPC)
(406) 813-1621
Entity
Organization
Contact information
Practice address
1045 REEVES RD STE C, BOZEMAN, MT 59718-7701
(406) 813-1621
Mailing address
PO BOX 69, BINGEN, WA 98605-0069
(406) 813-1621
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
02/02/2024
Last updated
06/24/2026
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