Organization
SOURCE COUNSELING COLLECTIVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW G. LEAR LCSW (OWNER)
(406) 589-5512
Entity
Organization
Contact information
Practice address
2415 W MAIN ST STE 2, BOZEMAN, MT 59718-3809
(406) 589-5512
Mailing address
4558 PERRY ST APT B, BOZEMAN, MT 59718-6661
(406) 589-5512
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/04/2021
Last updated
12/06/2021
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