# ADAM BOOMER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477420230
- **Authorized official:** ADAM BOOMER BBH-LCSW-LIC-81440 (THERAPIST)
- **Authorized official phone:** (406) 830-5095

## Contact information

- **Practice address:** 800 KENSINGTON AVE STE 201, MISSOULA, MT 59801-5670
- **Practice address phone:** (406) 830-5095
- **Mailing address:** 800 KENSINGTON AVE STE 201, MISSOULA, MT 59801-5674
- **Mailing address phone:** (406) 830-5095

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | Yes |
| 1041C0700X | Clinical Social Worker | — | — | Yes |

## Other

- **Enumeration date:** 10/17/2025
- **Last updated:** 10/24/2025