1881062719 NPI number — NADYNE BERNADETTE MONTIEL DE GAGNIER LCSW

Table of content: NADYNE BERNADETTE MONTIEL DE GAGNIER LCSW (NPI 1881062719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881062719 NPI number — NADYNE BERNADETTE MONTIEL DE GAGNIER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONTIEL DE GAGNIER
Provider First Name:
NADYNE
Provider Middle Name:
BERNADETTE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MONTIEL HIDALGO
Provider Other First Name:
NADYNE
Provider Other Middle Name:
BERNADETTE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW, LISW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1881062719
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 BANNOCK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80204-4507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 BANNOCK ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DENVER
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80204-4507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-436-6000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2015

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  077647 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: CSW.09925244 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com