Provider Demographics
NPI:1144374398
Name:CRUMMETT, LINDA (ACSW,LCSW)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:CRUMMETT
Suffix:
Gender:F
Credentials:ACSW,LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-5923
Mailing Address - Country:US
Mailing Address - Phone:406-259-1667
Mailing Address - Fax:406-245-2441
Practice Address - Street 1:304 GRAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-5923
Practice Address - Country:US
Practice Address - Phone:406-259-1667
Practice Address - Fax:406-245-2441
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0500162Medicaid