Provider Demographics
NPI:1255521035
Name:ZWERNER, KERI M (LCPC)
Entity type:Individual
Prefix:
First Name:KERI
Middle Name:M
Last Name:ZWERNER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1531 GALE CT
Mailing Address - Street 2:
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59718
Mailing Address - Country:US
Mailing Address - Phone:818-694-6982
Mailing Address - Fax:
Practice Address - Street 1:821 W. MENDENHALL ST
Practice Address - Street 2:#4
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-5971
Practice Address - Country:US
Practice Address - Phone:406-333-7993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-27
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-11745101Y00000X, 101YP2500X, 101YM0800X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional