Provider Demographics
NPI:1457002180
Name:LEITER, KAITLYN (LCSW)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:LEITER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 E ASPEN ST
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-3044
Mailing Address - Country:US
Mailing Address - Phone:717-201-6927
Mailing Address - Fax:
Practice Address - Street 1:414 E ASPEN ST
Practice Address - Street 2:
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-3044
Practice Address - Country:US
Practice Address - Phone:717-201-6927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-14
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty