Provider Demographics
NPI:1053501718
Name:FEATHERSTONE, LISA R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:R
Last Name:FEATHERSTONE
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 1:200 S. 23RD AVE. STE F1 #1046
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN,
Mailing Address - State:MT
Mailing Address - Zip Code:59718-2588
Mailing Address - Country:US
Mailing Address - Phone:406-599-6437
Mailing Address - Fax:
Practice Address - Street 1:1104 LOUISIANA ST
Practice Address - Street 2:
Practice Address - City:BELGRADE
Practice Address - State:MT
Practice Address - Zip Code:59714-8597
Practice Address - Country:US
Practice Address - Phone:406-599-6437
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-30
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI36351041C0700X
MT121761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical