Provider Demographics
NPI:1023264082
Name:BIRD, KARRIE J (LCPC)
Entity type:Individual
Prefix:
First Name:KARRIE
Middle Name:J
Last Name:BIRD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:KARRIE
Other - Middle Name:J
Other - Last Name:KLINK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1828
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-1828
Mailing Address - Country:US
Mailing Address - Phone:406-465-5938
Mailing Address - Fax:406-449-8828
Practice Address - Street 1:535 SADDLE DR
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-5634
Practice Address - Country:US
Practice Address - Phone:406-465-5938
Practice Address - Fax:406-449-8828
Is Sole Proprietor?:No
Enumeration Date:2008-08-11
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1380 LCPC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000744740OtherBLUE CROSS-SHIELD OF MONTANA PROVIDER #