Provider Demographics
NPI:1548626161
Name:TRIMBLE, MONICA (LCSW)
Entity type:Individual
Prefix:
First Name:MONICA
Middle Name:
Last Name:TRIMBLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 EASTSIDE HWY
Mailing Address - Street 2:
Mailing Address - City:STEVENSVILLE
Mailing Address - State:MT
Mailing Address - Zip Code:59870-2224
Mailing Address - Country:US
Mailing Address - Phone:406-777-2775
Mailing Address - Fax:406-327-4484
Practice Address - Street 1:3800 EASTSIDE HWY
Practice Address - Street 2:
Practice Address - City:STEVENSVILLE
Practice Address - State:MT
Practice Address - Zip Code:59870-2224
Practice Address - Country:US
Practice Address - Phone:406-777-2775
Practice Address - Fax:406-327-4484
Is Sole Proprietor?:No
Enumeration Date:2016-01-12
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSW 3681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical