| Manmade Mentors | |
|
1716 W Main St Ste 8c Bozeman MT 59715-6821 | |
| (406) 813-0301 | |
| Not Available |
| Full Name | Manmade Mentors |
|---|---|
| Speciality | Counselor |
| Location | 1716 W Main St Ste 8c, Bozeman, Montana |
| Authorized Official Name and Position | Shawn Helvey (OWNER) |
| Authorized Official Contact | 4068130301 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Manmade Mentors Po Box 4911 Maryville TN 37802-4911 Ph: (406) 813-0301 | Manmade Mentors 1716 W Main St Ste 8c Bozeman MT 59715-6821 Ph: (406) 813-0301 |
| NPI Number | 1619613270 |
|---|---|
| Provider Enumeration Date | 05/06/2022 |
| Last Update Date | 02/07/2025 |
| Certification Date | 02/07/2025 |
| Medicare PECOS PAC ID | 0941796080 |
|---|---|
| Medicare Enrollment ID | O20251229001442 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619613270 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | () | Secondary |
| 101YM0800X | Counselor - Mental Health | () | Primary |
| 101YP2500X | Counselor - Professional | () | Secondary |
| Provider Name | Glen Howard Stark |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1083486211 PECOS PAC ID: 1759867781 Enrollment ID: I20260109001164 |
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