Provider Demographics
NPI:1831730548
Name:BELLERIVE, NICOLLE MICHELLE (LCSW)
Entity type:Individual
Prefix:
First Name:NICOLLE
Middle Name:MICHELLE
Last Name:BELLERIVE
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 135
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:MT
Mailing Address - Zip Code:59047-0135
Mailing Address - Country:US
Mailing Address - Phone:406-223-9891
Mailing Address - Fax:
Practice Address - Street 1:330 S 3RD ST
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:MT
Practice Address - Zip Code:59047-3406
Practice Address - Country:US
Practice Address - Phone:406-223-9891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-03
Last Update Date:2022-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT278251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical