Provider Demographics
NPI:1114688173
Name:TOWNSEND, KIRSTEN K (LCPC, ACLC)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:K
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:LCPC, ACLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 S ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:CONRAD
Mailing Address - State:MT
Mailing Address - Zip Code:59425-2209
Mailing Address - Country:US
Mailing Address - Phone:815-858-4312
Mailing Address - Fax:
Practice Address - Street 1:600 S MAIN ST STE 10
Practice Address - Street 2:
Practice Address - City:CONRAD
Practice Address - State:MT
Practice Address - Zip Code:59425-2532
Practice Address - Country:US
Practice Address - Phone:815-858-4312
Practice Address - Fax:406-466-3485
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2022-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT57592101YP2500X
MT54164101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)