Provider Demographics
NPI:1679952873
Name:CLOUD, ABREI ANELLA (LCSW)
Entity type:Individual
Prefix:
First Name:ABREI
Middle Name:ANELLA
Last Name:CLOUD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7144
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59807-7144
Mailing Address - Country:US
Mailing Address - Phone:406-239-1753
Mailing Address - Fax:
Practice Address - Street 1:235 N 1ST ST W
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-3661
Practice Address - Country:US
Practice Address - Phone:406-239-1753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT118391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical