Provider Demographics
NPI:1386028223
Name:SPRADLIN, VIRGINIA (LCSW)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:SPRADLIN
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:PO BOX 815
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-0815
Mailing Address - Country:US
Mailing Address - Phone:406-862-4077
Mailing Address - Fax:406-862-4077
Practice Address - Street 1:100 2ND ST E
Practice Address - Street 2:SUITE 301A
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2410
Practice Address - Country:US
Practice Address - Phone:406-862-4077
Practice Address - Fax:406-862-4077
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-09
Last Update Date:2015-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTSWP-LCSW-LIC-6041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical