Healthcare Provider Details

I. General information

NPI: 1760221295
Provider Name (Legal Business Name): JENNIFER JOVIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/23/2024
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date: 02/25/2026
Reactivation Date: 09/03/2026

III. Provider practice location address

1601 2ND AVE N STE 110
GREAT FALLS MT
59401-3286
US

IV. Provider business mailing address

PO BOX 6542
GREAT FALLS MT
59406-6542
US

V. Phone/Fax

Practice location:
  • Phone: 406-426-1596
  • Fax:
Mailing address:
  • Phone: 406-788-5631
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-LCSW-LIC-90425
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: