Provider Demographics
NPI:1013564301
Name:OGGER, KELLY MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:MARIE
Last Name:OGGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1467 WESTCHESTER SQ S APT 2
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-1689
Mailing Address - Country:US
Mailing Address - Phone:406-694-4752
Mailing Address - Fax:
Practice Address - Street 1:1467 WESTCHESTER SQ S APT 2
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-1689
Practice Address - Country:US
Practice Address - Phone:406-694-4752
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-21
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-388851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical