Provider Demographics
NPI:1184448615
Name:FJARE, KASSIE ANN (SWLC)
Entity type:Individual
Prefix:
First Name:KASSIE
Middle Name:ANN
Last Name:FJARE
Suffix:
Gender:F
Credentials:SWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 SILVER FOX LN
Mailing Address - Street 2:
Mailing Address - City:BELGRADE
Mailing Address - State:MT
Mailing Address - Zip Code:59714-2301
Mailing Address - Country:US
Mailing Address - Phone:702-467-4048
Mailing Address - Fax:
Practice Address - Street 1:100 N 27TH ST STE 510
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-2054
Practice Address - Country:US
Practice Address - Phone:406-223-6827
Practice Address - Fax:406-919-4044
Is Sole Proprietor?:No
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-729191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical