Provider Demographics
NPI:1285895839
Name:AIRHART, KRISTIN ECKHOLM (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:ECKHOLM
Last Name:AIRHART
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:PO BOX 4587
Mailing Address - Street 2:ST PATRICK HOSPITAL & HEALTH SCIENCES CENTER
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59802-4587
Mailing Address - Country:US
Mailing Address - Phone:406-327-3209
Mailing Address - Fax:406-327-3505
Practice Address - Street 1:500 WEST BROADWAY
Practice Address - Street 2:ST PATRICK HOSPITAL & HEALTH SCIENCES CENTER
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4008
Practice Address - Country:US
Practice Address - Phone:406-327-3209
Practice Address - Fax:406-327-3505
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT8331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical