Individual
THOMAS JOHN BASOLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
3000 PALMER ST STE B, MISSOULA, MT 59808-1671
(406) 541-4673
Mailing address
3000 PALMER ST STE B, MISSOULA, MT 59808-1671
(406) 541-4673
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-64524
MT
1041C0700X
Clinical Social Worker
Primary
BBH-SWLC-LIC-71592
MT
Other
Enumeration date
09/19/2023
Last updated
01/21/2026
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