Provider Demographics
NPI:1306407846
Name:COLTON, GINA MCINTYRE (LCSW)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:MCINTYRE
Last Name:COLTON
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 1:335 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1722
Mailing Address - Country:US
Mailing Address - Phone:406-670-2169
Mailing Address - Fax:
Practice Address - Street 1:335 CLARK AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1722
Practice Address - Country:US
Practice Address - Phone:406-670-2169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-375501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical