Individual provider · Type 1 NPI

Coyote Fairbank, LCSW

Clinical Social Worker · Polson, MT

NPI number 1447783170 Active

Practice location

2 6th Ave E
Polson, MT 59860-2726

Call (406) 214-3137 Map

Mailing address

PO Box 181
Polson, MT 59860-0181

Other practice locations

7935 Mt Highway 35 Ste 202, Bigfork, MT 59911-5711 · (406) 214-3137
1602 2nd St W, Polson, MT 59860-4005 · (406) 214-3137

Specialties and licenses

Taxonomy	Code	License
Clinical Social Worker Primary	1041C0700X	BBH-LCSW-LIC-23635 (MT)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1447783170

Coyote Fairbank, LCSW's National Provider Identifier is 1447783170, issued on Apr 10, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Polson, MT. The record was last updated on Nov 27, 2023.