| Kimberly Brown Campbell, Edd, Lcpc, Atr, Inc | |
|
235 N 1st St W Suite 1 Missoula MT 59802-3661 | |
| (406) 396-6565 | |
| Not Available |
| Full Name | Kimberly Brown Campbell, Edd, Lcpc, Atr, Inc |
|---|---|
| Speciality | Counselor |
| Location | 235 N 1st St W, Missoula, Montana |
| Authorized Official Name and Position | Kimberly Brown Campbell (ART THERAPIST) |
| Authorized Official Contact | 4063966565 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Brown Campbell, Edd, Lcpc, Atr, Inc 511 E Pine St Missoula MT 59802-4635 Ph: (406) 396-6565 | Kimberly Brown Campbell, Edd, Lcpc, Atr, Inc 235 N 1st St W Suite 1 Missoula MT 59802-3661 Ph: (406) 396-6565 |
| NPI Number | 1740643758 |
|---|---|
| Provider Enumeration Date | 03/29/2016 |
| Last Update Date | 03/29/2016 |
| Medicare PECOS PAC ID | 0547603326 |
|---|---|
| Medicare Enrollment ID | O20240208002205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740643758 | NPI | - | NPPES |
| 1093953036 | Medicaid | MT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 1339 (Montana) | Primary |
| Provider Name | Kimberly Brown Campbell |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1093953036 PECOS PAC ID: 1456794239 Enrollment ID: I20240208002283 |
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