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General NPI Number Information
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NPI Number | 1083513063
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Entity Type | Individual
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Provider Name | PAUL EVERETT
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Gender | Male
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 2435 ANNIE ST
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City | BOZEMAN
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State | MT
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Zip | 59718-2789
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Country | US
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Telephone | 406-916-3075
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Fax |
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Provider Business Mailing Address
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Address Line | 3495 FEN WAY APT 1
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City | BOZEMAN
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State | MT
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Zip | 59718-7397
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BBH-SWLC-LIC-72599
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License Number State | MT
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