Provider Demographics
NPI:1922275197
Name:CARDIFF, JESSICA LEIGH (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:JESSICA
Middle Name:LEIGH
Last Name:CARDIFF
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:PO BOX 18262
Mailing Address - Street 2:
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59808-8262
Mailing Address - Country:US
Mailing Address - Phone:406-546-6791
Mailing Address - Fax:
Practice Address - Street 1:210 N HIGGINS AVE STE 227
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-4497
Practice Address - Country:US
Practice Address - Phone:406-721-2697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-15
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT6271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical