Provider Demographics
NPI:1073013728
Name:DEBBIE VIEGUT, LCSW, INC.
Entity Type:Organization
Organization Name:DEBBIE VIEGUT, LCSW, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VIEGUT
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-531-4470
Mailing Address - Street 1:3019 CRISCO LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-9676
Mailing Address - Country:US
Mailing Address - Phone:406-531-4470
Mailing Address - Fax:406-926-3009
Practice Address - Street 1:800 KENSINGTON AVE STE 211C
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-5670
Practice Address - Country:US
Practice Address - Phone:406-531-4470
Practice Address - Fax:406-926-3009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1136374011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT13682766OtherCAQH