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NPI Code Detail

MEDICARE: ALICE CLARK REUMAN LCSW

MEDICARE: ALICE CLARK REUMAN 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
11041C0700XClinical Social Worker886MT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10000071366OTHERMTBLUE CROSS-SHIELD OF MONTANA

General Provider Information

NPI Number : 1508094467
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALICE CLARK REUMAN LCSW
Provider Business Mailing Address
First Line : PO BOX 3089
Second Line : CENTER FOR MENTAL HEALTH
City : GREAT FALLS
State : MT
Zip : 59403-3089
Country : US
Telephone Number : 406-873-5538
Fax Number : 406-873-3348
Provider Business Practice Location Address
First Line : 1210 EAST MAIN STREET
Second Line : CENTER FOR MENTAL HEALTH COURT ANNEX
City : CUT BANK
State : MT
Zip : 59427-3152
Country : US
Telephone Number : 406-873-5538
Fax Number : 406-873-3348
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2009
Last Update Date : 08/26/2009

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