Provider Demographics
NPI:1407048937
Name:TUBBS, DEBRA LAUREE (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:LAUREE
Last Name:TUBBS
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 1:208 DAWSON ST
Mailing Address - Street 2:
Mailing Address - City:WOLF POINT
Mailing Address - State:MT
Mailing Address - Zip Code:59201-1627
Mailing Address - Country:US
Mailing Address - Phone:406-653-3135
Mailing Address - Fax:406-494-1724
Practice Address - Street 1:710 4TH AVE N
Practice Address - Street 2:
Practice Address - City:WOLF POINT
Practice Address - State:MT
Practice Address - Zip Code:59201-1212
Practice Address - Country:US
Practice Address - Phone:406-653-1653
Practice Address - Fax:406-494-1724
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2007-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT686OtherSTATE OF MONTANA LICENSE