Provider Demographics
NPI:1073653200
Name:ALT, KATHARINE M (MED, LPC)
Entity Type:Individual
Prefix:MS
First Name:KATHARINE
Middle Name:M
Last Name:ALT
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 N 31ST ST
Mailing Address - Street 2:SUITE 129
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-1211
Mailing Address - Country:US
Mailing Address - Phone:406-245-9812
Mailing Address - Fax:406-255-7125
Practice Address - Street 1:404 N 31ST ST
Practice Address - Street 2:SUITE 129
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1211
Practice Address - Country:US
Practice Address - Phone:406-245-9812
Practice Address - Fax:406-255-7125
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLPC 507101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0255476Medicaid
MT75066OtherBLUE CROSS BLUE SHIELD