Provider Demographics
NPI:1346631355
Name:BATEMAN, KATIE (LCPC)
Entity Type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:BATEMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:KURTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCPC
Mailing Address - Street 1:30989 ASPEN LN
Mailing Address - Street 2:
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-7554
Mailing Address - Country:US
Mailing Address - Phone:815-451-9393
Mailing Address - Fax:406-883-8448
Practice Address - Street 1:6 13TH AVE E
Practice Address - Street 2:
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-5315
Practice Address - Country:US
Practice Address - Phone:815-451-9393
Practice Address - Fax:406-883-8448
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2016-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT11463101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health