MEDICARE: SPOT TO TALK, A LICENSED CLINICAL SOCIAL WORKER CORPORATION

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1326673617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPOT TO TALK, A LICENSED CLINICAL SOCIAL WORKER CORPORATION

Provider Business Mailing Address
First Line	:	191 JEWEL BASIN CT STE 3D
Second Line	:
City	:	BIGFORK
State	:	MT
Zip	:	59911-6294
Country	:	US
Telephone Number	:	406-201-9711
Fax Number	:

Provider Business Practice Location Address
First Line	:	191 JEWEL BASIN CT STE 3D
Second Line	:
City	:	BIGFORK
State	:	MT
Zip	:	59911-6294
Country	:	US
Telephone Number	:	406-201-9711
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	CLAIRE ELIZABETH WICK
Credential	:	LCSW
Telephone Number	:	406-201-9711

Provider Enumeration Date	:	03/06/2020
Last Update Date	:	08/08/2023

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Directions to “SPOT TO TALK, A LICENSED CLINICAL SOCIAL WORKER CORPORATION ” Practice Location

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