Provider Demographics
NPI:1881062719
Name:MONTIEL DE GAGNIER, NADYNE BERNADETTE (LCSW)
Entity type:Individual
Prefix:
First Name:NADYNE
Middle Name:BERNADETTE
Last Name:MONTIEL DE GAGNIER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NADYNE
Other - Middle Name:BERNADETTE
Other - Last Name:MONTIEL HIDALGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, LISW
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4507
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:777 BANNOCK ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80204-4507
Practice Address - Country:US
Practice Address - Phone:303-436-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-09
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA0776471041C0700X
CSW.099252441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical