Provider Demographics
NPI:1467507129
Name:TWEEDY, BRUCE A (LCSW-P)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:A
Last Name:TWEEDY
Suffix:
Gender:M
Credentials:LCSW-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 NONE SUCH ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5859
Mailing Address - Country:US
Mailing Address - Phone:406-439-0852
Mailing Address - Fax:
Practice Address - Street 1:706 NONE SUCH ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5859
Practice Address - Country:US
Practice Address - Phone:406-439-0852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical