Healthcare Provider Details

I. General information

NPI: 1659210300
Provider Name (Legal Business Name): NORTH STAR COUNSELING & RECOVERY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2026
Last Update Date: 03/27/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 WEST JEFFERSON STREET PO BOX 978
THREE FORKS MT
59752
US

IV. Provider business mailing address

315 WEST JEFFERSON STREET PO BOX 978
THREE FORKS MT
59752
US

V. Phone/Fax

Practice location:
  • Phone: 406-490-9068
  • Fax:
Mailing address:
  • Phone: 406-490-9068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: JAY JOHNSON
Title or Position: COUNSELOR/OWNER
Credential: LAC
Phone: 406-490-9068