Healthcare Provider Details

I. General information

NPI: 1629582747
Provider Name (Legal Business Name): KATHRYN ANN CIRAOLO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 BOYER CREEK LN
PLAINS MT
59859-9609
US

IV. Provider business mailing address

3 BOYER CREEK LN
PLAINS MT
59859-9609
US

V. Phone/Fax

Practice location:
  • Phone: 267-374-0825
  • Fax: 406-213-0003
Mailing address:
  • Phone: 267-374-0825
  • Fax: 406-213-0003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number256387
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW010478
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSWC-27634
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW-40922
License Number StateID
# 5
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number4679C
License Number StateAL
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberTLHT-TPSW6492
License Number StateFL
# 7
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW015585
License Number StatePA
# 8
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSWI.LW.61151266
License Number StateWA
# 9
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberBBH-LCSW-LIC-23188
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: