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NPI Code Detail

MEDICARE: STEVE WELLINGTON LLC

MEDICARE: STEVE WELLINGTON LLC
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 Worker

General Provider Information

NPI Number : 1548739220
Entity Type Code : Organization
Provider Name (Legal Business Name) : STEVE WELLINGTON LLC
Provider Business Mailing Address
First Line : 366 TIMBERVIEW CIR
Second Line :
City : BOZEMAN
State : MT
Zip : 59718-8297
Country : US
Telephone Number : 603-986-7040
Fax Number :
Provider Business Practice Location Address
First Line : 251 EDELWEISS DR STE 1B
Second Line :
City : BOZEMAN
State : MT
Zip : 59718-3933
Country : US
Telephone Number : 603-986-7040
Fax Number :
Authorized Official
Title or Position : SOLE MBR
Name : STEVE WELLINGTON
Credential : LCSW
Telephone Number : 603-986-7040
Provider Enumeration Date : 11/25/2018
Last Update Date : 11/25/2018

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Directions to “STEVE WELLINGTON LLC ” Practice Location

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