MEDICARE: BOZEMAN SUPPORTIVE COUNSELING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1477316347
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOZEMAN SUPPORTIVE COUNSELING

Provider Business Mailing Address
First Line	:	PO BOX 69
Second Line	:
City	:	BINGEN
State	:	WA
Zip	:	98605-0069
Country	:	US
Telephone Number	:	406-813-1621
Fax Number	:

Provider Business Practice Location Address
First Line	:	1045 REEVES RD STE C
Second Line	:
City	:	BOZEMAN
State	:	MT
Zip	:	59718-7701
Country	:	US
Telephone Number	:	406-813-1621
Fax Number	:

Authorized Official
Title or Position	:	LCPC
Name	:	MS. MOLLY JO BASTA
Credential	:	LCPC
Telephone Number	:	406-813-1621

Provider Enumeration Date	:	02/02/2024
Last Update Date	:	06/24/2026

Similar Medicare Providers

1073147534 — CAITLIN BRANDL LCPC
Practice Location Address:

1045 REEVES RD STE D
BOZEMAN, MT
59718-7701

Practice Phone: 406-813-1566
Practice Fax:

1033879192 — ANNE CHRISTINE WYSOSKI MS, LCPC, LAC, SEP
Practice Location Address:

1045 REEVES RD STE D
BOZEMAN, MT
59718-7701

Practice Phone: 406-624-9131
Practice Fax:

1912306184 — CHRISTOPHER LUMSDEN PA-C
Practice Location Address:

875 S COTTONWOOD RD STE 200
BOZEMAN, MT
59718-4222

Practice Phone: 406-414-5336
Practice Fax: 406-414-5337

1619344249 — CHRISTINA M JAMIESON PA-C
Practice Location Address:

875 S COTTONWOOD RD STE 300
BOZEMAN, MT
59718-4221

Practice Phone: 406-414-5336
Practice Fax:

1619803210 — MARIA MICHELLE CROCCO CNM
Practice Location Address:

59 JOCKEY CT
BOZEMAN, MT
59718-1211

Practice Phone: 614-361-7497
Practice Fax:

1033045653 — LAUREN MARIE JESSEN PA-C
Practice Location Address:

309 UPPER VIOLET RD
BOZEMAN, MT
59718-7784

Practice Phone: 513-535-2658
Practice Fax:

Directions to “BOZEMAN SUPPORTIVE COUNSELING ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.