Connie S Dahl, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

756 Issued in MT

Practice address

213 6TH Ave S
Wolf Point, MT 59201-1517

Phone

(406) 653-1200

Fax

(406) 653-3104

NPI assigned

Jul 26, 2007

Last updated

Jul 26, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fort Peck Tribes

  dba Fort Peck Tribal Health

  • Federally Qualified Health Center (FQHC)
  • Poplar, MT
  • NPI 1609020080
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185408000000",
    "number": "1144410101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 JOHNSON ST",
            "city": "WOLF POINT",
            "state": "MT",
            "postal_code": "592011817",
            "telephone_number": "406-653-1472",
            "fax_number": "406-494-1724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 6TH AVE S",
            "city": "WOLF POINT",
            "state": "MT",
            "postal_code": "592011517",
            "telephone_number": "406-653-1200",
            "fax_number": "406-653-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAHL",
        "first_name": "CONNIE",
        "middle_name": "S",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-26",
        "last_updated": "2007-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "756",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MONTANA LICENSE",
            "identifier": "756",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Hunter Lawrence Burshia, ACLC
• Danica Chai
• Shania Rae Chavez, RN
• Casey Renea Cornett, R.D.H.
• Ellissa Andreen Cyr, B.A.
• Rebecca Suzanne Dayton, MT(ASCP)
• Crystal Dawn Decoteau
• Omar Fidel Espinosa, MLT
• Scott Wayne Falley, MD
• Jill Ranae Ferdina

• Clinical Social Worker in Wolf Point, MT
• Providers in Wolf Point, MT by specialty
• Clinical Social Worker in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.