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General NPI Number Information
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NPI Number | 1578444634
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Entity Type | Individual
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Provider Name | STEPHANIE LYNN SHAW SWLC
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Gender | Female
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Dates
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Enumeration Date | 09/08/2025
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Last Update Date | 09/08/2025
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Provider Practice Location Address
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Address Line | 34169 US HIGHWAY 2
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City | LIBBY
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State | MT
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Zip | 59923-8430
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Country | US
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Telephone | 406-293-3113
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Fax |
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Provider Business Mailing Address
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Address Line | 609 E 5TH ST
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City | LIBBY
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State | MT
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Zip | 59923-2367
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Country | US
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Telephone | 406-291-2721
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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-81356
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License Number State | MT
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