| Organization Name: | CAMILLA O. BERGSTROM LCSW PC |
| NPI Number: | 1013081637 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CAMILLA O. HURD (PRESIDENT) |
| Mailing Address: | 208 N 29th St Suites 236-237 Billings |
| State: | MT US |
| Postal Code: | 591011985 |
| Phone Number: | 4068991008 |
| Fax Number: | |
| NPI Enumeration Date: | 11/17/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 327 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |