Provider Demographics
NPI:1508094467
Name:REUMAN, ALICE CLARK (LCSW)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:CLARK
Last Name:REUMAN
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 3089
Mailing Address - Street 2:CENTER FOR MENTAL HEALTH
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-873-5538
Mailing Address - Fax:406-873-3348
Practice Address - Street 1:1210 EAST MAIN STREET
Practice Address - Street 2:CENTER FOR MENTAL HEALTH COURT ANNEX
Practice Address - City:CUT BANK
Practice Address - State:MT
Practice Address - Zip Code:59427-3152
Practice Address - Country:US
Practice Address - Phone:406-873-5538
Practice Address - Fax:406-873-3348
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2009-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000071366OtherBLUE CROSS-SHIELD OF MONTANA
MT011002880Medicare PIN