NPI 1104255637 · live from the CMS NPI Registry
Dacia Lee Antiste-Fisher, LCSW
Social Worker, Clinical in Polson, MT. National Provider Identifier 1104255637, active.
NPI record
| NPI | 1104255637 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Social Worker, Clinical 1041C0700X |
| Practice location | 5 4th Ave E, Polson, MT 59860 |
| Practice phone | 406-745-3525 |
| Mailing address | P.O. Box 880, St. Ignatius, MT 59865 |
| Enumerated | November 5, 2013 |
| Last updated | March 14, 2024 |
| Sole proprietor | Yes |
| Other names | Dacia Antiste |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Social Worker, Clinical primary | 1041C0700X | BBH-LCSW-LIC-30076 (MT) |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | 1930 (MT) |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | LAC-LAC-LIC-1930 (MT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.