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General NPI Number Information
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NPI Number | 1154183820
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Entity Type | Individual
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Provider Name | CHRISTINA BUCAREY LAC, SWLC
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Gender | Female
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 330 MAIN ST SW
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City | RONAN
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State | MT
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Zip | 59864-2707
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Country | US
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Telephone | 406-872-0630
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Fax | 406-203-9949
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Provider Business Mailing Address
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Address Line | 330 MAIN ST SW
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City | RONAN
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State | MT
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Zip | 59864-2707
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BBH-SWLC-LIC-81246
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License Number State | MT
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | BBH-LAC-LIC-72665
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License Number State | MT
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