Provider Demographics
NPI:1255457073
Name:MCKAIN, TED LOREN (LCPC)
Entity type:Individual
Prefix:MR
First Name:TED
Middle Name:LOREN
Last Name:MCKAIN
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 SPOKANE AVE
Mailing Address - Street 2:SUITE 7
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2677
Mailing Address - Country:US
Mailing Address - Phone:406-862-0337
Mailing Address - Fax:406-752-5222
Practice Address - Street 1:244 SPOKANE AVE
Practice Address - Street 2:SUITE 7
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2677
Practice Address - Country:US
Practice Address - Phone:406-862-0337
Practice Address - Fax:406-752-5222
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT812101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT251566Medicaid