Provider Demographics
NPI:1912659467
Name:OVERVOLD, KIMBERLY C (LCSW, LAC)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:C
Last Name:OVERVOLD
Suffix:
Gender:F
Credentials:LCSW, 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 20882
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59104-0882
Mailing Address - Country:US
Mailing Address - Phone:406-855-3501
Mailing Address - Fax:
Practice Address - Street 1:902 WYOMING AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-1637
Practice Address - Country:US
Practice Address - Phone:406-855-3501
Practice Address - Fax:406-794-0491
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-25
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-ACLC-LIC-48621101YA0400X
MTBBH-SWLC-LIC-439851041C0700X
MTBBH-LCSW-LIC-572751041C0700X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty