Healthcare Provider Details

I. General information

NPI: 1518793470
Provider Name (Legal Business Name): MACLEAN DUBAY MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2385 MOUNT ELLIS LN
BOZEMAN MT
59715-9236
US

IV. Provider business mailing address

511 N 17TH AVE
BOZEMAN MT
59715-3111
US

V. Phone/Fax

Practice location:
  • Phone: 440-708-4955
  • Fax:
Mailing address:
  • Phone: 440-708-4955
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number90157
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: