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Individual

LISA BRUBAKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
334 TOWN CENTER AVE, BIG SKY, MT 59716
(406) 414-5000
Mailing address
915 HIGHLAND BLVD, BOZEMAN, MT 59715-6902

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
BBH-LCSW-LIC-8150
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7193589
MT
Enumeration date
10/21/2014
Last updated
04/15/2025
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