Healthcare Provider Details

I. General information

NPI: 1538332838
Provider Name (Legal Business Name): ROBERT BAKKO D MIN LCPC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 DIVISION ST SUITE 200
BILLINGS MT
59101-6030
US

IV. Provider business mailing address

1004 DIVISION ST SUITE 200
BILLINGS MT
59101-6030
US

V. Phone/Fax

Practice location:
  • Phone: 406-259-6161
  • Fax: 406-294-0967
Mailing address:
  • Phone: 406-259-6161
  • Fax: 406-294-0967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number17 LCPC
License Number StateMT

VIII. Authorized Official

Name: ROBERT BAKKO
Title or Position: OWNER
Credential: LCPC
Phone: 406-259-6161