Provider Demographics
NPI:1174907885
Name:KATHRYN TRUCANO LCPC LLC
Entity type:Organization
Organization Name:KATHRYN TRUCANO LCPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDIVIDUAL AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:A
Authorized Official - Last Name:TRUCANO
Authorized Official - Suffix:
Authorized Official - Credentials:MS, NCC, LCPC
Authorized Official - Phone:406-992-4082
Mailing Address - Street 1:PO BOX 257
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59624-0257
Mailing Address - Country:US
Mailing Address - Phone:406-992-4082
Mailing Address - Fax:406-992-5876
Practice Address - Street 1:825 HELENA AVE
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-3459
Practice Address - Country:US
Practice Address - Phone:406-992-4082
Practice Address - Fax:406-992-5876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-9297251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health