Provider Demographics
NPI:1093801300
Name:GUMPER, LINDELL LEWIS (JD, PHD)
Entity Type:Individual
Prefix:DR
First Name:LINDELL
Middle Name:LEWIS
Last Name:GUMPER
Suffix:
Gender:M
Credentials:JD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 NORTH BROADWAY
Mailing Address - Street 2:SUITE 822
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101
Mailing Address - Country:US
Mailing Address - Phone:406-446-4422
Mailing Address - Fax:
Practice Address - Street 1:303 NORTH BROADWAY
Practice Address - Street 2:SUITE 822
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101
Practice Address - Country:US
Practice Address - Phone:406-446-4422
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT146103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT51940OtherBLUE CROSS BLUE SHIELD