Lara Fowler
Individual provider Active NPI Clinical Social Worker · Conrad, MT
NPI 1972133395 · NPPES record last updated Apr 24, 2023
Key facts
- NPI
- 1972133395
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- BBH-LCSW-LIC-43400 (MT)
- Practice address
- 600 S Main St Ste 10
Conrad, MT 59425-2532 - Phone
- (406) 201-9414
- Fax
- (406) 278-0330
- NPI assigned
- Jan 24, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BBH-LCSW-LIC-43400 | MT | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Front Counseling LLC | Current |
Accepting new patients | |
| Onyx Counseling & Consultation | Clinical | Current |
Accepting new patients |
Locations
600 S Main St
Ste 10
Conrad, MT 59425
Phone (406) 278-0440
19 4th Ave SW
Ste 3
Conrad, MT 59425
Phone (406) 201-9414
1601 2nd Ave N
Ste 350
Great Falls, MT 59401
Phone (406) 201-9414
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Clinical Social Worker | 1041C0700X | BBH-LCSW-LIC-43400 | MT | Yes |
Addresses
Primary practice location
600 S Main St Ste 10
Conrad, MT 59425-2532
Mailing address
600 S Main St Ste 10
Conrad, MT 59425-2532
Phone (406) 201-9414
Other practice location 1
1601 2nd Ave N Ste 350
Great Falls, MT 59401-3259
Phone (406) 201-9414
Other providers in Conrad, MT
- Conrad School District
- Clifford Wayne Davis
- Keri Lynn Degroat
- Eastern Front Counseling LLC
- Farm View Dental PLLC
- Bethanie Nicole Funderburk
- Golden Triangle Compounding, LLC
- Patricia J Grena
- Ilene Birnell Hawkinson
- Michael M Hewett
All providers in Conrad, MT · Clinical Social Worker in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 24, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.