Healthcare Provider Details

I. General information

NPI: 1083071187
Provider Name (Legal Business Name): KYSA E RASMUSSEN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2016
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 5TH ST SW
SIDNEY MT
59270-3643
US

IV. Provider business mailing address

1100 5TH ST SW
SIDNEY MT
59270-3643
US

V. Phone/Fax

Practice location:
  • Phone: 406-433-7539
  • Fax: 406-433-9186
Mailing address:
  • Phone: 406-433-7539
  • Fax: 406-433-9186

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16010
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: