Provider Demographics
NPI:1376698803
Name:VANMARLE, ROBERT A F (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A F
Last Name:VANMARLE
Suffix:
Gender:M
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:557 US HIGHWAY 93 S
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:MT
Mailing Address - Zip Code:59840-9710
Mailing Address - Country:US
Mailing Address - Phone:406-363-6900
Mailing Address - Fax:
Practice Address - Street 1:557 US HIGHWAY 93 S
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:MT
Practice Address - Zip Code:59840-9710
Practice Address - Country:US
Practice Address - Phone:406-363-6900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
071370OtherBCBS
MT0502741Medicaid
MT0810645OtherMEDICAID