Individual
ADAM BOOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
800 KENSINGTON AVE STE 201, MISSOULA, MT 59801-5674
(406) 830-5095
Mailing address
2750 TERRACE DR, MISSOULA, MT 59803-9732
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-81440
MT
1041C0700X
Clinical Social Worker
Primary
BBH-SWLC-LIC-53919
MT
Other
Enumeration date
12/23/2021
Last updated
02/17/2026
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