Provider Demographics
NPI:1477832467
Name:KOHLER, MICHELLE ELIZABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ELIZABETH
Last Name:KOHLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ELIZABETH
Other - Last Name:BILTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 3089
Mailing Address - Street 2:CENTER FOR MENTAL HEALTH
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-761-2100
Mailing Address - Fax:406-791-9629
Practice Address - Street 1:3420 15TH AVE S
Practice Address - Street 2:CENTER FOR MENTAL HEALTH/MOUNTAIN VIEW
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-5514
Practice Address - Country:US
Practice Address - Phone:406-761-2100
Practice Address - Fax:406-791-9629
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MT120531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0MT0702913OtherBLUE CROSS-BLUE SHIELD OF MONTANA
MT0MT0702913OtherBLUE CROSS-BLUE SHIELD OF MONTANA