Provider Demographics
NPI:1891570735
Name:SHON, KEVIN M (LCSW)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:M
Last Name:SHON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:929 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4429
Mailing Address - Country:US
Mailing Address - Phone:406-729-6645
Mailing Address - Fax:
Practice Address - Street 1:44 N LAST CHANCE GULCH STE 14
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4158
Practice Address - Country:US
Practice Address - Phone:406-729-6645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-29
Last Update Date:2024-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBHH-LCSW-LIC-645391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical