Provider Demographics
NPI:1396408225
Name:MCCLAIN, KYLIE M (LAC-C)
Entity Type:Individual
Prefix:
First Name:KYLIE
Middle Name:M
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:LAC-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-4517
Mailing Address - Country:US
Mailing Address - Phone:406-294-9609
Mailing Address - Fax:406-245-4886
Practice Address - Street 1:1001 S 27TH ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-4517
Practice Address - Country:US
Practice Address - Phone:406-294-9609
Practice Address - Fax:406-245-4886
Is Sole Proprietor?:No
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-ACLC-LIC-50287101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)