=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962146381
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KATE ALEXANDRA SEAHOLM LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/21/2022
-----------------------------------------------------
Last Update Date | 09/05/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 E PARK AVE
-----------------------------------------------------
City | ANACONDA
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59711-2340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-563-8117
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 E PARK AVE
-----------------------------------------------------
City | ANACONDA
-----------------------------------------------------
State | MT
-----------------------------------------------------
Zip | 59711-2340
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 406-563-8117
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | BBH-LCSW-LIC-55535
-----------------------------------------------------
License Number State | MT
-----------------------------------------------------