Terran Eastham

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

BBH-LCSW-LIC-71509 Issued in MT

Practice address

2601 S 3Rd St W
Missoula, MT 59804-1143

Phone

(406) 414-9623

NPI assigned

Mar 24, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Terran Brown Former name

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Glacier Trails Counseling LLC

  • Clinical Social Worker
  • Missoula, MT
  • NPI 1265260285
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1235889288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16331",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598086331",
            "telephone_number": "406-414-9623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 S 3RD ST W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598041143",
            "telephone_number": "406-414-9623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EASTHAM",
        "first_name": "TERRAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "BBH-LCSW-LIC-71509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERRAN",
            "last_name": "BROWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dylan Claxton, LCSW, PLLC
• Kyle Dyrud
• Conor Dysinger, FNP-C
• Kendall Earle
• Early Blossoms Speech Therapy
• Melissa Eastlick, LCSW
• Easy Living Caregiving, LLC
• Eat Move Grow LLC
• Eating Disorder Center of Montana
• Lillian Eaton

• Clinical Social Worker in Missoula, MT
• Providers in Missoula, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.