Individual
MARTINA JANE NELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LAC,CMHP
Contact information
Practice address
603 CALIFORNIA AVE, LIBBY, MT 59923-1901
(406) 293-7116
(406) 293-8119
Mailing address
603 CALIFORNIA AVENUE, LIBBY, MT 59923
(406) 293-7116
(406) 293-8119
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
954
MT
1041C0700X
Clinical Social Worker
Primary
799
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0044707
—
MT
Enumeration date
08/03/2006
Last updated
11/13/2009
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