Provider Demographics
NPI:1134728181
Name:KINSLEY, CAROLINE (MA, LPC, BC-DMT)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:KINSLEY
Suffix:
Gender:F
Credentials:MA, LPC, BC-DMT
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 1904
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59806-1904
Mailing Address - Country:US
Mailing Address - Phone:406-201-9736
Mailing Address - Fax:
Practice Address - Street 1:3700 S RUSSELL ST STE B110
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8574
Practice Address - Country:US
Practice Address - Phone:406-201-9736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-21
Last Update Date:2025-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC7603101YM0800X
MTBBH-LCPC-LIC-64926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health