Keller, Susan Clark
Keller, Susan Clark is an individual health care provider with primary practice located at 307 1St Ave East Ste 3, Kalispell MT 59901-4965. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Keller, Susan Clark can be contacted via phone (406) 257-3877.Contact Information
Primary practice address
307 1St Ave East Ste 3
Kalispell MT 59901-4965
Phone: (406) 257-3877
Fax: (406) 257-3907
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 582LCSW | Montana |
Profile Details
| NPI number | 1760436125 |
|---|---|
| LBN Legal business name | Keller, Susan Clark |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760436125 | NPPES |
| Montana | MEDICAID | 0502537 |
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