MEDICARE: TIA JAYLYNN ROBINETTE MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	37602	MT

General Provider Information

NPI Number	:	1093477911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIA JAYLYNN ROBINETTE MSW, LCSW

Provider Business Mailing Address
First Line	:	PO BOX 30352
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59107-0352
Country	:	US
Telephone Number	:	406-272-6583
Fax Number	:

Provider Business Practice Location Address
First Line	:	2812 1ST AVE N STE 424
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59101-2312
Country	:	US
Telephone Number	:	406-272-6583
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/07/2021
Last Update Date	:	07/25/2024

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