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Contact Information

CHASE GANNON
202 BROOKS ST STE 300
MISSOULA, MT59801-4019
 Phone: 406-926-1453
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction (Substance Use Disorder)

103TA0400X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for CHASE GANNON · (Male)

NPI # 1265223382
Status Active
Credentials
Entity Individual
Enumeration date 05/16/2025
Last updated 05/16/2025 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • MT License # BBH-LAC-LIC-79686
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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