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NPI Code Detail

MEDICARE: KEVIN H COTTRILL L.C.S.W.

MEDICARE:   KEVIN H COTTRILL  L.C.S.W.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor1246MT
2101YM0800XMental Health Counselor409MT

General Provider Information

NPI Number : 1083931828
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN H COTTRILL L.C.S.W.
Provider Business Mailing Address
First Line : 3687 VETERANS DR
Second Line :
City : FORT HARRISON
State : MT
Zip : 59636-9700
Country : US
Telephone Number : 406-442-6410
Fax Number :
Provider Business Practice Location Address
First Line : 3687 VETERANS DR
Second Line :
City : FORT HARRISON
State : MT
Zip : 59636-9700
Country : US
Telephone Number : 406-442-6410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2010
Last Update Date : 04/17/2017

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