Healthcare Provider Details

I. General information

NPI: 1962673145
Provider Name (Legal Business Name): KATHRYN WARNER PH.D, LCPC, LPC, NCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/17/2008
Last Update Date: 10/12/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 10TH AVE S STE. #4
GREAT FALLS MT
59405-2680
US

IV. Provider business mailing address

1720 10TH AVE S STE. #4
GREAT FALLS MT
59405-2680
US

V. Phone/Fax

Practice location:
  • Phone: 406-899-0600
  • Fax: 866-666-2907
Mailing address:
  • Phone: 406-899-0600
  • Fax: 866-666-2907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberACC-7079
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC-4925
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberBBH-LCPC-LIC-7831
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: