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General NPI Number Information
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NPI Number | 1346631355
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Entity Type | Individual
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Provider Name | KATIE BATEMAN LCPC
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Gender | Female
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 11/17/2016
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Provider Practice Location Address
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Address Line | 6 13TH AVE E
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City | POLSON
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State | MT
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Zip | 59860-5315
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Country | US
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Telephone | 815-451-9393
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Fax | 406-883-8448
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Provider Business Mailing Address
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Address Line | 30989 ASPEN LN
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City | POLSON
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State | MT
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Zip | 59860-7554
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Country | US
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Telephone | 815-451-9393
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Fax | 406-883-8448
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 11463
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License Number State | MT
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