Provider Demographics
NPI:1194734566
Name:BRYSON, CINDY R (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CINDY
Middle Name:R
Last Name:BRYSON
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:PO BOX 2550
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-2550
Mailing Address - Country:US
Mailing Address - Phone:406-239-2911
Mailing Address - Fax:406-258-0178
Practice Address - Street 1:1600 NORTH AVE W STE 106
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-5500
Practice Address - Country:US
Practice Address - Phone:406-239-2911
Practice Address - Fax:406-258-0178
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT762LCSW104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0035529Medicaid
MT71655OtherBCBS