Provider Demographics
NPI:1699518969
Name:TOROK, JANE (SWLC)
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:TOROK
Suffix:
Gender:F
Credentials:SWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MARTINEZ SPRING RD
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718-7820
Mailing Address - Country:US
Mailing Address - Phone:406-548-4311
Mailing Address - Fax:
Practice Address - Street 1:1716 W MAIN ST STE 8C
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-6821
Practice Address - Country:US
Practice Address - Phone:406-813-0301
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-648781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical