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Coyote Fairbank, LCSW — NPI 1447783170, Polson, MT | NPI Central

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NPI 1447783170

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Coyote Fairbank, LCSW

NPI 1447783170 · Clinical Social Worker · Polson, MT

Provider details

NPI number: 1447783170
Entity type: Individual
Primary specialty: Clinical Social WorkerBehavioral Health & Social Service Providers
Credential: LCSW
Sex: Male
Sole proprietor: Yes
License: BBH-LCSW-LIC-23635 (MT)

Specialties & taxonomies

Clinical Social WorkerPrimary1041C0700XLicense BBH-LCSW-LIC-23635 (MT)
Behavioral Health & Social Service Providers

Practice location

2 6th Ave E

Polson, MT 59860-2726

Phone: (406) 214-3137

Approximate (ZIP-level) locationGet directions

More MT providers

Mailing address

Po Box 181

Polson, MT 59860-0181

Additional practice locations (2)

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

Registry dates

Enumerated: 2017-04-10
Last updated: 2023-11-27
Certified: 2020-10-14

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.