Provider Demographics
NPI:1528384500
Name:HANSON, BRIDGET TROY (LCSW)
Entity Type:Individual
Prefix:
First Name:BRIDGET
Middle Name:TROY
Last Name:HANSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:BRIDGET
Other - Middle Name:TERESA
Other - Last Name:TROY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1601 2ND AVE N STE 450
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59401-3288
Mailing Address - Country:US
Mailing Address - Phone:406-231-6869
Mailing Address - Fax:
Practice Address - Street 1:1601 2ND AVE N STE 450
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401
Practice Address - Country:US
Practice Address - Phone:406-231-6859
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2018-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0MT0705123OtherBLUE CROSS-SHIELD OF MONTANA
MT0000070098OtherBLUE CROSS-SHIELD OF MONTANA
MT0MT0705123OtherBLUE CROSS-SHIELD OF MONTANA