Provider Demographics
NPI:1427219070
Name:FIELDS, DAVID RALPH (MSW LAC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:RALPH
Last Name:FIELDS
Suffix:
Gender:M
Credentials:MSW LAC
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 4587
Mailing Address - Street 2:SAINT PATRICK HOSPITAL & HEALTH SCIENCES CENTER
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4587
Mailing Address - Country:US
Mailing Address - Phone:406-327-3200
Mailing Address - Fax:406-327-3500
Practice Address - Street 1:500 WEST BROADWAY
Practice Address - Street 2:SAINT PATRICK HOSPITAL & HEALTH SCIENCES CENTER
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4008
Practice Address - Country:US
Practice Address - Phone:406-327-3200
Practice Address - Fax:406-327-3500
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1037101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)