Provider Demographics
NPI:1285022905
Name:KIRBY-ZIMMERMAN, HANNAH EILEEN (LCPC)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:EILEEN
Last Name:KIRBY-ZIMMERMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 755
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-0755
Mailing Address - Country:US
Mailing Address - Phone:406-214-2459
Mailing Address - Fax:
Practice Address - Street 1:1119 W KENT AVE
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-6636
Practice Address - Country:US
Practice Address - Phone:406-214-2459
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-05
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI441-228106H00000X
MTBBH-LCPC-LIC-42636101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist