Provider Demographics
NPI:1437169968
Name:NAUTS, TAMMERA V (LCSW, LAC)
Entity Type:Individual
Prefix:MRS
First Name:TAMMERA
Middle Name:V
Last Name:NAUTS
Suffix:
Gender:F
Credentials:LCSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 WYOMING ST
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801
Mailing Address - Country:US
Mailing Address - Phone:406-532-9900
Mailing Address - Fax:406-532-9901
Practice Address - Street 1:1201 WYOMING ST.
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801
Practice Address - Country:US
Practice Address - Phone:406-532-9900
Practice Address - Fax:406-532-9901
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT994101YA0400X
MT4861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT000050224Medicare ID - Type Unspecified