Provider Demographics
NPI:1497773980
Name:O'REILLY, NELLIE FAITH (MSW, LCSW, RPT)
Entity Type:Individual
Prefix:MS
First Name:NELLIE
Middle Name:FAITH
Last Name:O'REILLY
Suffix:
Gender:F
Credentials:MSW, LCSW, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 RIMINI RD
Mailing Address - Street 2:
Mailing Address - City:LAKESIDE
Mailing Address - State:MT
Mailing Address - Zip Code:59922-9623
Mailing Address - Country:US
Mailing Address - Phone:406-750-5784
Mailing Address - Fax:
Practice Address - Street 1:203 RIMINI RD
Practice Address - Street 2:
Practice Address - City:LAKESIDE
Practice Address - State:MT
Practice Address - Zip Code:59922-9623
Practice Address - Country:US
Practice Address - Phone:406-750-5784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
4047201OtherBHP PREFERRED ONE
321G6OROtherBCBS
136290OtherU CARE
974602100OtherMHCP