Provider Demographics
NPI:1043065022
Name:GOTSCHALL, KATLYN ANN (MS, LCPC)
Entity type:Individual
Prefix:MRS
First Name:KATLYN
Middle Name:ANN
Last Name:GOTSCHALL
Suffix:
Gender:F
Credentials:MS, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 DUVAL DR
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MT
Mailing Address - Zip Code:59044-3653
Mailing Address - Country:US
Mailing Address - Phone:406-697-9487
Mailing Address - Fax:
Practice Address - Street 1:1011 DUVAL DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MT
Practice Address - Zip Code:59044-3653
Practice Address - Country:US
Practice Address - Phone:406-697-9487
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-22
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-70410101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor