Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kimberly Wallis Panko, MA

Individual provider Counselor · NPI 1245840230

Kimberly Wallis Panko, MA is a Mental Health Counselor in Missoula, Montana. Qualified in 2009, 17 years ago. Practices with Deer Oaks Mental Health Associates PC, a 54-clinician group and accepts Medicare assignment. Licensed in Alaska and Montana.

Years since qualifying
17
Licensed in
AK, MT
In the registry since
2020
Specialties on file
4
What do these letters mean?
MA — Master of Arts
A graduate arts degree.

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Practice location Address checks out

7955 Toby Way
Missoula, MT 59808-5024
Phone: (406) 219-1302
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence BBH-LCPC-LIC-50086 (MT)
Counselor Taxonomy 101Y00000X · Licence BBH-LCPC-LIC-50086 (MT)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 4630 (AK)
Mental Health Counselor Taxonomy 101YM0800X · Licence 169890 (AK)

Record details

NPI number1245840230
Entity typeIndividual (Type 1)
GenderFemale
Credentials MA
Sole proprietorYes
NPI enumeratedAugust 4, 2020
Last updated in NPPESOctober 24, 2024
Certification dateOctober 24, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Deer Oaks Mental Health Associates Pc — 54 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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