Provider Demographics
NPI:1063137586
Name:WEST, KATIE (PCLC)
Entity type:Individual
Prefix:
First Name:KATIE
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:PCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 N LAST CHANCE GULCH STE V355
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5062
Mailing Address - Country:US
Mailing Address - Phone:406-401-0113
Mailing Address - Fax:
Practice Address - Street 1:100 E BROADWAY ST
Practice Address - Street 2:
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-9351
Practice Address - Country:US
Practice Address - Phone:406-401-0113
Practice Address - Fax:406-401-0114
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-06
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-PCLC-LIC-57112101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health