Provider Demographics
NPI:1427243658
Name:WAPLES, KIM (LCSW)
Entity type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:WAPLES
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 3089
Mailing Address - Street 2:
Mailing Address - City:GREAT FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59403-3089
Mailing Address - Country:US
Mailing Address - Phone:406-443-7151
Mailing Address - Fax:406-443-3420
Practice Address - Street 1:900 JACKSON ST
Practice Address - Street 2:CENTER FOR MENTAL HEALTH
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601
Practice Address - Country:US
Practice Address - Phone:406-443-7151
Practice Address - Fax:406-443-3420
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1113101YA0400X
MT6181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0000070766OtherBLUE CROSS-SHIELD OF MONTANA PROVIDER #
MT0000070766OtherBLUE CROSS-SHIELD OF MONTANA PROVIDER #