Active NPI
Lyndon Robert Kacick, LAC
- Addiction (Substance Use Disorder) Counselor
- Livingston, MT
National Provider Identifier
1275830010
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 1250
- Practice address
- 517 S 10TH St
Livingston, MT 59047-3710 - Phone
- (406) 223-3864
- NPI assigned
- Feb 14, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 1250 | MT | Primary |
Addresses
Primary practice location
517 S 10TH St
Livingston, MT 59047-3710
Mailing address
517 S 10TH St
Livingston, MT 59047-3710
Phone (406) 223-3864
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1250 | MT | MD | Clinical Genetics (M.D.) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297641600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297641600000",
"number": "1275830010",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "517 S 10TH ST",
"city": "LIVINGSTON",
"state": "MT",
"postal_code": "590473710",
"telephone_number": "406-223-3864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "517 S 10TH ST",
"city": "LIVINGSTON",
"state": "MT",
"postal_code": "590473710",
"telephone_number": "406-223-3864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KACICK",
"first_name": "LYNDON",
"middle_name": "ROBERT",
"credential": "LAC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-02-14",
"last_updated": "2011-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MT",
"license": "1250",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livingston, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.