Provider Demographics
NPI:1679342166
Name:LABUDA, KASEY LYNN (SWLC)
Entity type:Individual
Prefix:
First Name:KASEY
Middle Name:LYNN
Last Name:LABUDA
Suffix:
Gender:F
Credentials:SWLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 COMMONS LOOP STE B
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-1919
Mailing Address - Country:US
Mailing Address - Phone:406-262-3885
Mailing Address - Fax:
Practice Address - Street 1:165 COMMONS LOOP STE B
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-1919
Practice Address - Country:US
Practice Address - Phone:406-262-3885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-26
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-SWLC-LIC-555461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty