Provider Demographics
NPI:1629475058
Name:TRUCANO, KATHRYN ANN (LCPC (MT); LCMHC (VT)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:ANN
Last Name:TRUCANO
Suffix:
Gender:F
Credentials:LCPC (MT); LCMHC (VT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 257
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-3459
Mailing Address - Country:US
Mailing Address - Phone:406-992-4082
Mailing Address - Fax:888-657-1446
Practice Address - Street 1:825 HELENA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3488
Practice Address - Country:US
Practice Address - Phone:406-992-4082
Practice Address - Fax:888-657-1446
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2022-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-9297101YM0800X, 101YP2500X
VT068.0134346101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1629475058Medicaid