| Doctor Name: | DAVID STANLEY KETCHELL |
| NPI Number: | 1598142838 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | SWP-LCPC-LIC-11980 |
| Business Practice Address: | 519 E Main St Cut Bank, MT - 594273015 |
| Business Phone Number: | 4068735670 |
| Business Fax Number: | 4068732256 |
| Mailing Address: | 519 E Main St, CUT BANK |
| State: | MT |
| Postal Code: | 594273015 |
| Phone Number: | 4068735670 |
| Fax Number: | 4068732256 |
| NPI Enumeration Date: | 05/06/2015 |
| NPI Last Update Date: | 05/06/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | SWP-LCPC-LIC-11980 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MT |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |