Healthcare Provider Details

I. General information

NPI: 1386810018
Provider Name (Legal Business Name): LINDA A SPANG LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2008
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 S 26TH ST
BILLINGS MT
59101-4163
US

IV. Provider business mailing address

PO BOX 30856
BILLINGS MT
59107-0856
US

V. Phone/Fax

Practice location:
  • Phone: 406-256-6825
  • Fax: 406-294-0967
Mailing address:
  • Phone: 406-256-6825
  • Fax: 406-294-0967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number378 LCSW
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: