Provider Demographics
NPI:1730417577
Name:KIDWELL, NEIL E (LCSW)
Entity type:Individual
Prefix:MR
First Name:NEIL
Middle Name:E
Last Name:KIDWELL
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4514 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-4922
Mailing Address - Country:US
Mailing Address - Phone:406-860-0430
Mailing Address - Fax:406-252-1176
Practice Address - Street 1:3212 1ST AVE S
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-3824
Practice Address - Country:US
Practice Address - Phone:406-245-2751
Practice Address - Fax:406-256-7026
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT9061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical