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Contact Information

MARY K NISSEN, LCSW
407 MAIN ST SW
RONAN, MT59864-2710
 Phone: 406-210-8831
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

1041C0700X 80 Licensed Clinical Social Worker
 

Social Worker

104100000X
Indicates primary specialty

NPI Profile & details for MARY K NISSEN · (Female)

NPI # 1760735682
Status Active
Credentials LCSW (Licensed Clinical Social Worker)
Entity Individual
Enumeration date 10/16/2012
Last updated 12/01/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • AK License # 189560
  • MT License # 66438
  • AK Medicaid MH0150
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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