Kaylee Virginia Blackwell, LAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Missoula, MT
NPI 1902207160 · NPPES record last updated May 30, 2025
Key facts
- NPI
- 1902207160
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- BBH-LAC-LIC-4154 (MT)
- Practice address
- 2001 S Russell St
Missoula, MT 59801-6621 - Phone
- (406) 493-0143
- Fax
- (406) 542-6632
- NPI assigned
- Sep 8, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| BBH-LAC-LIC-4154 | MT | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | |||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | BBH-LAC-LIC-4154 | MT | Yes |
Addresses
Primary practice location
2001 S Russell St
Missoula, MT 59801-6621
Mailing address
2001 S Russell St
Missoula, MT 59801-6621
Phone (406) 493-0143
Other providers in Missoula, MT
- Black Bear Naturopathic Clinic, PC
- Riley Davis Blackhurst
- Russell D Blackhurst
- Blackwell Behavioral Health
- Jacob Blackwell
- Katherine Blaedow
- Donald Robert Blair
- Jolynn Marie Blakeley
- Benjamin Blakely
- Kimberly Blakeslee
All providers in Missoula, MT · Addiction (Substance Use Disorder) Counselor in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.