Provider Demographics
NPI:1881608578
Name:WORKMAN POLLINGTON, SUE ANNE TANNER (PHD, LCSW, LAC)
Entity type:Individual
Prefix:DR
First Name:SUE ANNE
Middle Name:TANNER
Last Name:WORKMAN POLLINGTON
Suffix:
Gender:F
Credentials:PHD, LCSW, LAC
Other - Prefix:
Other - First Name:SUE
Other - Middle Name:ANNE
Other - Last Name:WORKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD LCSW, LAC
Mailing Address - Street 1:1023 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HAVRE
Mailing Address - State:MT
Mailing Address - Zip Code:59501-4106
Mailing Address - Country:US
Mailing Address - Phone:406-217-5222
Mailing Address - Fax:
Practice Address - Street 1:1023 5TH ST
Practice Address - Street 2:
Practice Address - City:HAVRE
Practice Address - State:MT
Practice Address - Zip Code:59501-4106
Practice Address - Country:US
Practice Address - Phone:406-217-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT352 LCSW1041C0700X
MT1253101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV01752-COtherNEVADA LCSW LICENSE
MT000070165OtherBLUE CROSS/SHIELD OF MONT
MT1253 LACOtherLAC
MT352 LCSWOtherLCSW
CA16797OtherCALIFORNIA LCSW LICENSE
CA16797OtherCALIFORNIA LCSW LICENSE