Provider Demographics
NPI:1649021403
Name:NUSSMAN, CHRISTOPHER (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:NUSSMAN
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:NUSSMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:730 3RD AVE E
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA FALLS
Mailing Address - State:MT
Mailing Address - Zip Code:59912-3511
Mailing Address - Country:US
Mailing Address - Phone:910-777-8012
Mailing Address - Fax:
Practice Address - Street 1:644 4TH AVE W
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5206
Practice Address - Country:US
Practice Address - Phone:406-756-3950
Practice Address - Fax:406-756-3957
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCSW-LIC-705041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical