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General NPI Number Information
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NPI Number | 1992289284
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Entity Type | Organization
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Legal Business Name | PARKSIDE COUNSELING LLC
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Dates
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Enumeration Date | 09/21/2018
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Last Update Date | 11/17/2025
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Provider Practice Location Address
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Address Line | 50 2ND ST E # B-15
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City | KALISPELL
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State | MT
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Zip | 59901-4509
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Country | US
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Telephone | 406-885-0350
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Fax |
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Provider Business Mailing Address
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Address Line | 2120 SNOWGHOST DR
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City | WHITEFISH
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State | MT
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Zip | 59937-7922
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Country | US
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Telephone | 406-885-0350
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | CORY KOHM
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Credential | LCPC
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Telephone | 406-885-0350
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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