Healthcare Provider Details

I. General information

NPI: 1083013585
Provider Name (Legal Business Name): TRANSITIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2014
Last Update Date: 08/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6230 MAIN ST
COLSTRIP MT
59323-9520
US

IV. Provider business mailing address

PO BOX 864
COLSTRIP MT
59323-0864
US

V. Phone/Fax

Practice location:
  • Phone: 406-671-7141
  • Fax:
Mailing address:
  • Phone: 406-671-7141
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number7971
License Number StateMT

VIII. Authorized Official

Name: BRENDA HAMILTON
Title or Position: OWNER
Credential: LCSW
Phone: 406-671-7141