Provider Demographics
NPI:1255150132
Name:MCCAULAY, KURT (MSW, LAC)
Entity type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:MCCAULAY
Suffix:
Gender:M
Credentials:MSW, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:LEWISTOWN
Mailing Address - State:MT
Mailing Address - Zip Code:59457-0303
Mailing Address - Country:US
Mailing Address - Phone:406-707-0437
Mailing Address - Fax:
Practice Address - Street 1:311 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISTOWN
Practice Address - State:MT
Practice Address - Zip Code:59457-2760
Practice Address - Country:US
Practice Address - Phone:406-707-0437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LAC-LIC-70667101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)