Provider Demographics
NPI:1356542161
Name:LINCOLN, PATRICIA A (LCSW,LAC)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:A
Last Name:LINCOLN
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 1:157 MEADOWLARK CT
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-2625
Mailing Address - Country:US
Mailing Address - Phone:406-370-6305
Mailing Address - Fax:
Practice Address - Street 1:157 MEADOWLARK CT
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803
Practice Address - Country:US
Practice Address - Phone:406-370-6305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1200101YA0400X
MT10101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)