Healthcare Provider Details

I. General information

NPI: 1841443652
Provider Name (Legal Business Name): KATHERINE ANN ONEILL LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2008
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 N WHITEHALL ST ALTACARE
WHITEHALL MT
59759-7713
US

IV. Provider business mailing address

3738 HARRISON AVE ALTACARE
BUTTE MT
59701-6823
US

V. Phone/Fax

Practice location:
  • Phone: 406-287-3882
  • Fax: 406-497-7918
Mailing address:
  • Phone: 406-287-3882
  • Fax: 406-497-7918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1576
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: