Provider Demographics
NPI:1730826892
Name:NICOLLE BELLERIVE LCSW LLC
Entity type:Organization
Organization Name:NICOLLE BELLERIVE LCSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICOLLE
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:BELLERIVE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:406-223-9891
Mailing Address - Street 1:PO BOX 135
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-0135
Mailing Address - Country:US
Mailing Address - Phone:406-223-9891
Mailing Address - Fax:
Practice Address - Street 1:126 E CALLENDER ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-2675
Practice Address - Country:US
Practice Address - Phone:406-223-9891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-18
Last Update Date:2022-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health