Healthcare Provider Details

I. General information

NPI: 1871300160
Provider Name (Legal Business Name): VICTORIA JAGER LCPC, LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VICTORIA LAFORGE LAC, PCLC

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3616 9TH AVE N
GREAT FALLS MT
59401-2227
US

IV. Provider business mailing address

3616 9TH AVE N
GREAT FALLS MT
59401-2227
US

V. Phone/Fax

Practice location:
  • Phone: 406-350-3589
  • Fax:
Mailing address:
  • Phone: 406-350-3589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-LCPC-LIC-74928
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: