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NPI Code Detail

MEDICARE: CODY ELIZABETH PORTWINE-KINZER LCSW

MEDICARE: CODY ELIZABETH PORTWINE-KINZER LCSW
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
11041C0700XClinical Social Worker768WY
21041C0700XClinical Social Worker2382MT

General Provider Information

NPI Number : 1942461223
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY ELIZABETH PORTWINE-KINZER LCSW
Provider Business Mailing Address
First Line : PO BOX 1530
Second Line :
City : MILES CITY
State : MT
Zip : 59301-1530
Country : US
Telephone Number : 406-234-1687
Fax Number :
Provider Business Practice Location Address
First Line : 2508 WILSON ST
Second Line :
City : MILES CITY
State : MT
Zip : 59301-5000
Country : US
Telephone Number : 406-234-1687
Fax Number : 406-234-1698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2008
Last Update Date : 10/04/2012

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Directions to “ CODY ELIZABETH PORTWINE-KINZER LCSW” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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