Provider Demographics
NPI:1881736924
Name:KEARNEY, MARGARET SUSAN (LCSW)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:SUSAN
Last Name:KEARNEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 MAIN ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:POLSON
Mailing Address - State:MT
Mailing Address - Zip Code:59860-5333
Mailing Address - Country:US
Mailing Address - Phone:406-883-0002
Mailing Address - Fax:406-883-0998
Practice Address - Street 1:1201 MAIN ST
Practice Address - Street 2:SUITE A
Practice Address - City:POLSON
Practice Address - State:MT
Practice Address - Zip Code:59860-5333
Practice Address - Country:US
Practice Address - Phone:406-883-0002
Practice Address - Fax:406-883-0998
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT521LCSW1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0502588Medicaid
MT70125OtherBLUE CROSS - BLUE SHIELD
MT87726OtherUNITED BEHAVIORAL HEALTH