Jasmine Marie Van Antwerp | Bozeman, MT • PECOS Search

Jasmine Marie Van Antwerp

Counselor

Behavioral Health & Social Service Providers

313 W Mendenhall St, Suite 10, Bozeman, MT 59715-3479

PECOS Enrollment

Based on the most recent information from CMS, provider Jasmine Marie Van Antwerp does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1912333436
Provider Type
Individual
Full Name
Van Antwerp, Jasmine Marie
Title
Mrs.
Credential
MS, LCPC

Gender
Female
Sole Proprietor
No
Enumeration Date
9/16/2013
Last Updated
9/23/2015

Contact Information

Practice Location

313 W Mendenhall St, Suite 10, Bozeman, MT 59715-3479

Unlisted Fax

Mailing Location

313 W Mendenhall St, Suite 10, Bozeman, MT 59715-3479

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 101YP2500X Primary	Description Counselor Behavioral Health & Social Service Providers	License 4679 Montana