Provider Demographics
NPI:1215705363
Name:HADLEY, JOANNA LYNN (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:LYNN
Last Name:HADLEY
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:527 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-1788
Mailing Address - Country:US
Mailing Address - Phone:415-987-3963
Mailing Address - Fax:
Practice Address - Street 1:527 OXFORD DR
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-1788
Practice Address - Country:US
Practice Address - Phone:415-987-3963
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-63262101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health