Healthcare Provider Details

I. General information

NPI: 1598413270
Provider Name (Legal Business Name): KATY THOMAS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2022
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 1ST ST W STE 202
POLSON MT
59860-2602
US

IV. Provider business mailing address

302 1ST ST W STE 202
POLSON MT
59860-2602
US

V. Phone/Fax

Practice location:
  • Phone: 406-600-6415
  • Fax: 406-258-0576
Mailing address:
  • Phone: 406-600-6415
  • Fax: 406-258-0576

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number45990
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: