Healthcare Provider Details

I. General information

NPI: 1902545569
Provider Name (Legal Business Name): CATHERINE KOLCZAK MS, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CATIE KOLCZAK MS, LCPC

II. Dates (important events)

Enumeration Date: 06/01/2022
Last Update Date: 05/31/2024
Certification Date: 05/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1732 S 72ND ST W
BILLINGS MT
59106-3538
US

IV. Provider business mailing address

817 22ND ST W
BILLINGS MT
59102-3903
US

V. Phone/Fax

Practice location:
  • Phone: 406-655-2100
  • Fax:
Mailing address:
  • Phone: 406-697-2919
  • Fax: 406-206-0393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-55970
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: