Nicole Deneen Craig, LISW-S, LCSW
Individual provider Active NPI Clinical Social Worker · Monarch, MT
NPI 1689179392 · NPPES record last updated Jul 8, 2024
Key facts
- NPI
- 1689179392
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- BBH-LCSW-LIC-70344 (MT)
- Practice address
- 16 Bear Coulee LN
Monarch, MT 59463-7719 - Phone
- (419) 512-5032
- Fax
- (614) 383-7786
- NPI assigned
- Mar 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| BBH-LCSW-LIC-70344 | MT | MD | Clinical Social Worker |
| I.0005798-S | OH | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | I.0005798-S | OH | |
| Clinical Social Worker | 1041C0700X | BBH-LCSW-LIC-70344 | MT | Yes |
Addresses
Primary practice location
16 Bear Coulee LN
Monarch, MT 59463-7719
Mailing address
16 Bear Coulee LN
Monarch, MT 59463-7719
Phone (419) 512-5032
Other names
- Mrs. Nicole Deneen Keller
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2024. 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.