Provider Demographics
NPI:1669818068
Name:DEGEL, MARIE F (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIE
Middle Name:F
Last Name:DEGEL
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 1:9504 BOROUGH PARK ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89178-8295
Mailing Address - Country:US
Mailing Address - Phone:702-445-6474
Mailing Address - Fax:
Practice Address - Street 1:615 2ND AVE N
Practice Address - Street 2:
Practice Address - City:GREAT FALLS
Practice Address - State:MT
Practice Address - Zip Code:59401-2585
Practice Address - Country:US
Practice Address - Phone:406-452-9048
Practice Address - Fax:406-452-9053
Is Sole Proprietor?:No
Enumeration Date:2013-05-13
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-494451041C0700X
225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTBBH-LCSW-LIC-49445OtherLICENSED CLINICAL SOCIAL WORKER