Provider Demographics
NPI:1962673145
Name:WARNER, KATHRYN (PHD, LCPC, LPC, NCC)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:WARNER
Suffix:
Gender:F
Credentials:PHD, LCPC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 10TH AVE S
Mailing Address - Street 2:STE. #4
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59405-2680
Mailing Address - Country:US
Mailing Address - Phone:406-899-0600
Mailing Address - Fax:866-666-2907
Practice Address - Street 1:1720 10TH AVE S
Practice Address - Street 2:STE. #4
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59405-2680
Practice Address - Country:US
Practice Address - Phone:406-899-0600
Practice Address - Fax:866-666-2907
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC-4925101YP2500X
COACC-7079101YA0400X
MTBBH-LCPC-LIC-7831101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)