Healthcare Provider Details

I. General information

NPI: 1740521764
Provider Name (Legal Business Name): TRACI L SHINABARGER LCSW, MPA, BCBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2013
Last Update Date: 01/15/2026
Certification Date: 01/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

735 E BROADWAY
HELENA MT
59601-4313
US

IV. Provider business mailing address

735 E BROADWAY
HELENA MT
59601-4313
US

V. Phone/Fax

Practice location:
  • Phone: 406-552-5762
  • Fax:
Mailing address:
  • Phone: 406-552-5762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-LCSW-LIC-847
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBCBA 1-12-11885
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: