| Davis Logan, SWLC, MSW | |
|
14 Charis Ln, Missoula, MT 59802-3516 | |
| (313) 802-1073 | |
| Not Available |
| Full Name | Davis Logan |
|---|---|
| Gender | Male |
| Speciality | Clinical Social Worker |
| Experience | 5 Years |
| Location | 14 Charis Ln, Missoula, Montana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275297939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 44181 (Montana) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Missoula Therapy Pllc | 1254686025 | 2 |
| Entity Name | Missoula Therapy Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225528110 PECOS PAC ID: 1254686025 Enrollment ID: O20180619001875 |
| Mailing Address | Practice Location Address |
|---|---|
| Davis Logan, SWLC, MSW 14 Charis Ln, Missoula, MT 59802-3516 Ph: (313) 802-1073 | Davis Logan, SWLC, MSW 14 Charis Ln, Missoula, MT 59802-3516 Ph: (313) 802-1073 |
Jennifer Walrod, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 111 Hillcrest Loop, Missoula, MT 59803 Phone: 406-529-7776 Fax: 866-776-9460 | |
Jocelyn Nelson, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 520 S 3rd St W, Missoula, MT 59801 Phone: 406-240-3732 | |
Jennifer Nichole Tuttle, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 155 N California St Apt 407, Missoula, MT 59801 Phone: 919-395-2269 | |
Mckenna Leigh Fromm, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3885 W Broadway St, Missoula, MT 59808 Phone: 406-465-8725 | |
Mark Christopher Wayne, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 401 Railroad St W, Missoula, MT 59802 Phone: 406-830-5584 | |
Ms. Kaitlyn Nina Bosshardt, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 401 Railroad St W, Missoula, MT 59802 Phone: 406-258-4789 Fax: 406-258-4732 | |
Calia Ivy, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2112 Dixon Ave, Missoula, MT 59801 Phone: 928-637-8354 |