Timothy Leslie Dallacqua, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

895 Issued in MT

Practice address

600 Central Ave
Suite 305
Great Falls, MT 59401-3179

Phone

(406) 868-8017

NPI assigned

Apr 27, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680220800000",
    "number": "1467710442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CENTRAL AVE",
            "address_2": "SUITE 305",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013179",
            "telephone_number": "406-868-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CENTRAL AVE",
            "address_2": "SUITE 305",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013179",
            "telephone_number": "406-868-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLACQUA",
        "first_name": "TIMOTHY",
        "middle_name": "LESLIE",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-27",
        "last_updated": "2023-03-31",
        "certification_date": "2023-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "895",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David D Dachs, DDS
• Linda Schuler Daggett, LCPC
• Larae Ann Dahl, PHARMD
• Daisy Incontinence and Medical Supply, LLC
• Jenna Rae Dalla Mura, PTA
• Nishan Dallakoti, M.D.
• Daniel R Walker MD PLLC
• James H Daniel Jr., M.D.
• Heather Daniels, PHARMD, RPH
• Marcie Dardis, LAC, LPN

• Clinical Social Worker in Great Falls, MT
• Providers in Great Falls, 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 Mar 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.