Healthcare Provider Details

I. General information

NPI: 1548626161
Provider Name (Legal Business Name): MONICA TRIMBLE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2016
Last Update Date: 01/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 EASTSIDE HWY
STEVENSVILLE MT
59870-2224
US

IV. Provider business mailing address

3800 EASTSIDE HWY
STEVENSVILLE MT
59870-2224
US

V. Phone/Fax

Practice location:
  • Phone: 406-777-2775
  • Fax: 406-327-4484
Mailing address:
  • Phone: 406-777-2775
  • Fax: 406-327-4484

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW 368
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: