Healthcare Provider Details

I. General information

NPI: 1740102912
Provider Name (Legal Business Name): KATHERINE TAYLOR DAVIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 S MAIN ST
LIVINGSTON MT
59047-2623
US

IV. Provider business mailing address

PO BOX 83
LIVINGSTON MT
59047-0083
US

V. Phone/Fax

Practice location:
  • Phone: 406-414-9802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberBBH-PCLC-LIC-90084
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: