Provider Demographics
NPI:1679723571
Name:KIMBRELL, DANIELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:KIMBRELL
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:PO BOX 217
Mailing Address - Street 2:
Mailing Address - City:FORTINE
Mailing Address - State:MT
Mailing Address - Zip Code:59918-0217
Mailing Address - Country:US
Mailing Address - Phone:406-297-7900
Mailing Address - Fax:
Practice Address - Street 1:99 MILLS SPRING RD
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MT
Practice Address - Zip Code:59917-9153
Practice Address - Country:US
Practice Address - Phone:406-297-7900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2009-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical