Provider Demographics
NPI:1326274770
Name:WHISMAN-BLAIR, CAROLINE ANNES (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ANNES
Last Name:WHISMAN-BLAIR
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 1:1627 W MAIN ST # 238
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4011
Mailing Address - Country:US
Mailing Address - Phone:360-556-7188
Mailing Address - Fax:
Practice Address - Street 1:201 S WILLSON AVE STE C
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4602
Practice Address - Country:US
Practice Address - Phone:360-556-7188
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-29
Last Update Date:2020-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical