Healthcare Provider Details

I. General information

NPI: 1356236780
Provider Name (Legal Business Name): CUB HAVEN COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2025
Last Update Date: 06/09/2025
Certification Date: 06/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 2ND AVE N STE 514
GREAT FALLS MT
59401-3289
US

IV. Provider business mailing address

1601 2ND AVE N STE 514
GREAT FALLS MT
59401-3289
US

V. Phone/Fax

Practice location:
  • Phone: 406-590-5095
  • Fax:
Mailing address:
  • Phone: 406-590-5095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TERESA MOUSER
Title or Position: CLINICAL DIRECTOR
Credential: LAC, LCPC, SAP, MAC
Phone: 406-590-1550