Provider Demographics
NPI:1699309997
Name:LOMBARDI-THORMAN, SARA HEPBURN (LAC, MSW)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:HEPBURN
Last Name:LOMBARDI-THORMAN
Suffix:
Gender:F
Credentials:LAC, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2831
Mailing Address - Country:US
Mailing Address - Phone:406-862-3898
Mailing Address - Fax:
Practice Address - Street 1:709 PARK AVE
Practice Address - Street 2:
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2831
Practice Address - Country:US
Practice Address - Phone:406-862-3898
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-25
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1083101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty