Healthcare Provider Details

I. General information

NPI: 1194808949
Provider Name (Legal Business Name): CAMILLA O HURD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CAMILLA O. BERGSTROM LCSW

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N 29TH ST SUITES 236-237
BILLINGS MT
59101-1985
US

IV. Provider business mailing address

533 EVANS RICEVILLE RD
BELT MT
59412-8400
US

V. Phone/Fax

Practice location:
  • Phone: 406-899-1008
  • Fax: 406-736-5321
Mailing address:
  • Phone: 406-736-5613
  • Fax: 406-736-5321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMT327
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: