Provider Demographics
NPI:1366177099
Name:BUCHEIT, CAMERON LYNN (PCLC)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:LYNN
Last Name:BUCHEIT
Suffix:
Gender:F
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5439 TEE PEE DR.
Mailing Address - Street 2:FLORENCE
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801
Mailing Address - Country:US
Mailing Address - Phone:406-544-7812
Mailing Address - Fax:
Practice Address - Street 1:2237 S 3RD ST W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-1334
Practice Address - Country:US
Practice Address - Phone:406-233-0118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-18
Last Update Date:2022-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-56689101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor