Healthcare Provider Details

I. General information

NPI: 1669030854
Provider Name (Legal Business Name): KATRINE ANN SETTERSTROM LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 06/03/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 S MONTANA ST
BUTTE MT
59701-2840
US

IV. Provider business mailing address

309 GRANITE MOUNTAIN RD
BUTTE MT
59701-2880
US

V. Phone/Fax

Practice location:
  • Phone: 406-533-2973
  • Fax:
Mailing address:
  • Phone: 406-491-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-37831
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: