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Provider Information for 1487843041


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JASON NEWCOMB LCPC


Sex: Male

NPI: 1487843041
Last Updated: 2015-05-29
Certification Date:

Details

NameValue
NPI1487843041
Enumeration Date2007-10-19
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 55 BASIN CREEK RD
BUTTE, MT 59701-9704
United States

Phone: 406-497-7894 | Fax:
 
Primary Practice Address 55 BASIN CREEK RD
BUTTE, MT 59701-9704
United States

Phone: 406-497-7894 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 101YM0800X - Counselor - Mental HealthMTSWP-LCPC-LIC-11472