Provider Demographics
NPI:1770296386
Name:DK COUNSELING 406
Entity type:Organization
Organization Name:DK COUNSELING 406
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:KOBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-591-0094
Mailing Address - Street 1:1925 GRAND AVE STE 121
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-2762
Mailing Address - Country:US
Mailing Address - Phone:406-591-0094
Mailing Address - Fax:
Practice Address - Street 1:1925 GRAND AVE STE 121
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-2762
Practice Address - Country:US
Practice Address - Phone:406-591-0094
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-28
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT1386153658Medicaid