Healthcare Provider Details

I. General information

NPI: 1326673617
Provider Name (Legal Business Name): SPOT TO TALK, A LICENSED CLINICAL SOCIAL WORKER CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2020
Last Update Date: 08/08/2023
Certification Date: 08/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

191 JEWEL BASIN CT STE 3D
BIGFORK MT
59911-6294
US

IV. Provider business mailing address

191 JEWEL BASIN CT STE 3D
BIGFORK MT
59911-6294
US

V. Phone/Fax

Practice location:
  • Phone: 406-201-9711
  • Fax:
Mailing address:
  • Phone: 406-201-9711
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CLAIRE ELIZABETH WICK
Title or Position: DIRECTOR
Credential: LCSW
Phone: 406-201-9711