Provider Demographics
NPI:1699515551
Name:MERRIMAN, KYLIE ANN (LCPC)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:ANN
Last Name:MERRIMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 RAY OF HOPE LN
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59106-3502
Mailing Address - Country:US
Mailing Address - Phone:406-656-2198
Mailing Address - Fax:
Practice Address - Street 1:1750 RAY OF HOPE LN
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59106-3502
Practice Address - Country:US
Practice Address - Phone:406-656-2198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-70705101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional