Healthcare Provider Details

I. General information

NPI: 1518803915
Provider Name (Legal Business Name): ELIZABETH KASEL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2026
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 S WILLSON AVE
BOZEMAN MT
59715-6232
US

IV. Provider business mailing address

70 CARRIAGE LN
BURNSVILLE MN
55306-5083
US

V. Phone/Fax

Practice location:
  • Phone: 406-717-6498
  • Fax:
Mailing address:
  • Phone: 480-299-1121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number23690
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number34094
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: