Constance Andvik, S.W.
Individual provider Active NPI Social Worker · Poplar, MT
NPI 1144320888 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1144320888
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 242 (MT)
- Practice address
- 107 H. St. East
550 6TH Ave. No.
Poplar, MT 59255 - Phone
- (406) 768-3491
- Fax
- (406) 768-3423
- NPI assigned
- Sep 23, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 242 | MT | MD | Massage Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 242 | MT | Yes |
Addresses
Primary practice location
107 H. St. East
550 6TH Ave. No.
Poplar, MT 59255
Mailing address
107 H. St. East
Poplar, MT 59255
Phone (406) 768-3491
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2210068 | Medicaid | MT | |
| 242 | Other | MT | MT. ST. BOARD |
Other providers in Poplar, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.