Provider Demographics
NPI:1679636542
Name:WEBB, ELIZABETH JOHNSTON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JOHNSTON
Last Name:WEBB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:BETSY
Other - Middle Name:J
Other - Last Name:WEBB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:8373 GOLDENSTEIN LN
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-6694
Mailing Address - Country:US
Mailing Address - Phone:406-522-0412
Mailing Address - Fax:
Practice Address - Street 1:104 E MAIN ST
Practice Address - Street 2:SUITE 310
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4760
Practice Address - Country:US
Practice Address - Phone:406-579-8699
Practice Address - Fax:406-586-8745
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical