Individual
GRETA JERNBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LAC, LCSW
Contact information
Practice address
800 KENSINGTON AVE STE LL2, MISSOULA, MT 59801-5670
(406) 529-2712
Mailing address
800 KENSINGTON AVE STE LL2, MISSOULA, MT 59801-5670
(406) 529-2712
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
BBH-LAC-LIC-13136
MT
1041C0700X
Clinical Social Worker
Primary
21727
MT
Other
Enumeration date
12/04/2015
Last updated
03/08/2017
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