Provider Demographics
NPI:1497209514
Name:ARMSTRONG, KATELYN MOORE (MA, LCPC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:MOORE
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:KATELYN
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, LCPC
Mailing Address - Street 1:725 SW HIGGINS AVE STE B
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59803-1420
Mailing Address - Country:US
Mailing Address - Phone:406-396-5383
Mailing Address - Fax:
Practice Address - Street 1:725 SW HIGGINS AVE STE B
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59803-1420
Practice Address - Country:US
Practice Address - Phone:406-396-5383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-05
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT18669101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health