Provider Demographics
NPI:1629013255
Name:BAUMGARTNER, TONDY MOSS (LCSW)
Entity type:Individual
Prefix:MS
First Name:TONDY
Middle Name:MOSS
Last Name:BAUMGARTNER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4425 SNOWSHOE LN
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1743
Mailing Address - Country:US
Mailing Address - Phone:406-549-8281
Mailing Address - Fax:406-243-5275
Practice Address - Street 1:4425 SNOWSHOE LN
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1743
Practice Address - Country:US
Practice Address - Phone:406-549-8281
Practice Address - Fax:406-243-5275
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT7471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical