Provider Demographics
NPI:1629270905
Name:LALICKER, DAYNEN JEAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DAYNEN
Middle Name:JEAN
Last Name:LALICKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:84 OHIO ST
Mailing Address - Street 2:STE 4
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1806
Mailing Address - Country:US
Mailing Address - Phone:406-646-2470
Mailing Address - Fax:406-299-3911
Practice Address - Street 1:84 OHIO ST
Practice Address - Street 2:STE 4
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1806
Practice Address - Country:US
Practice Address - Phone:406-565-2709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-31
Last Update Date:2023-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT5323-LCSW1041C0700X
KS56711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical