Provider Demographics
NPI:1700388295
Name:WANDEL, KATE (MSW)
Entity Type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:WANDEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 HELENA AVE #305
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-3106
Mailing Address - Country:US
Mailing Address - Phone:406-324-2808
Mailing Address - Fax:
Practice Address - Street 1:616 HELENA AVE STE 305
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3654
Practice Address - Country:US
Practice Address - Phone:406-449-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-19046104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker