Healthcare Provider Details

I. General information

NPI: 1386561637
Provider Name (Legal Business Name): LISA LAIRD SWLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1645 AVENUE D STE C
BILLINGS MT
59102-3043
US

IV. Provider business mailing address

1645 AVENUE D STE C
BILLINGS MT
59102-3043
US

V. Phone/Fax

Practice location:
  • Phone: 406-272-2511
  • Fax: 406-224-4574
Mailing address:
  • Phone: 406-272-2511
  • Fax: 406-224-4574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-SWLC-LIC-89864
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: