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General NPI Number Information
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NPI Number | 1821713868
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Entity Type | Individual
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Provider Name | KATIE MARIE ENGLESON LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/11/2022
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Last Update Date | 01/23/2025
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Provider Practice Location Address
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Address Line | 2825 STOCKYARD RD STE A15
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City | MISSOULA
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State | MT
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Zip | 59808-1545
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Country | US
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Telephone | 401-753-3350
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Fax |
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Provider Business Mailing Address
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Address Line | 619 SW HIGGINS AVE
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City | MISSOULA
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State | MT
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Zip | 59803-1467
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Country | US
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Telephone | 405-203-5755
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Fax |
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BBH-LCSW-LIC-57552
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | BBH-LCSW-55158
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License Number State | MT
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