Individual ProviderLeslie Haaland DominickCounselorBehavioral Health & Social Service ProvidersPractice Address2050 Fairway Dr Ste 203, Bozeman, MT 59715-5810(406) 478-6611PECOS EnrollmentBased on the most recent information from CMS, provider Leslie Haaland Dominick does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1821758012Provider TypeIndividualFull NameDominick, Leslie HaalandTitleMs.CredentialMS, LCPCGenderFemaleSole ProprietorYesEnumeration Date12/29/2021Last Updated12/29/2021Contact InformationPractice LocationPractice Address2050 Fairway Dr Ste 203, Bozeman, MT 59715-5810Phone(406) 478-6611FaxUnlisted FaxMailing LocationMailing Address10619 Kelly Canyon Rd, Bozeman, MT 59715-9688Phone(406) 478-6611FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YP2500XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseBBH-LCPC-LIC-50557MontanaCode101YM0800XDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseBBH-LCPC-LIC-50557Montana