| Blue Gumballs Unlimited Pc | |
|
21 N Last Chance Gulch St Suite 209 Helena MT 59601-4109 | |
| (406) 443-8780 | |
| (406) 443-4550 |
| Full Name | Blue Gumballs Unlimited Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 21 N Last Chance Gulch St, Helena, Montana |
| Authorized Official Name and Position | Randi B Levin (LICENSED CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 4064438780 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Gumballs Unlimited Pc 21 N Last Chance Gulch St Suite 209 Helena MT 59601-4109 Ph: (406) 443-8780 | Blue Gumballs Unlimited Pc 21 N Last Chance Gulch St Suite 209 Helena MT 59601-4109 Ph: (406) 443-8780 |
| NPI Number | 1427071810 |
|---|---|
| Provider Enumeration Date | 07/26/2006 |
| Last Update Date | 02/18/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427071810 | NPI | - | NPPES |
| 0000502860 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW 478 (Montana) | Primary |
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