Provider Demographics
NPI:1083036305
Name:QUICK, STEPHANIE (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:QUICK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 BROOKLYN AVE
Mailing Address - Street 2:
Mailing Address - City:SUPERIOR
Mailing Address - State:MT
Mailing Address - Zip Code:59872-9607
Mailing Address - Country:US
Mailing Address - Phone:406-822-4278
Mailing Address - Fax:406-258-4732
Practice Address - Street 1:405 BROOKLYN ST
Practice Address - Street 2:
Practice Address - City:SUPERIOR
Practice Address - State:MT
Practice Address - Zip Code:59872-9607
Practice Address - Country:US
Practice Address - Phone:406-532-9150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-07
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT3358101YA0400X
MT439171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)