Provider Demographics
NPI:1922138114
Name:GALLACHER, KATHLEEN KAUFMAN (LCPC)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:KAUFMAN
Last Name:GALLACHER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20160 E CARLTON CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MT
Mailing Address - Zip Code:59833
Mailing Address - Country:US
Mailing Address - Phone:406-396-9099
Mailing Address - Fax:
Practice Address - Street 1:1802 DEARBORN AVE
Practice Address - Street 2:STE 202
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801
Practice Address - Country:US
Practice Address - Phone:406-396-9099
Practice Address - Fax:844-401-8626
Is Sole Proprietor?:No
Enumeration Date:2007-03-06
Last Update Date:2018-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1248101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0257244Medicaid