Healthcare Provider Details

I. General information

NPI: 1881062719
Provider Name (Legal Business Name): NADYNE BERNADETTE MONTIEL DE GAGNIER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: NADYNE BERNADETTE MONTIEL HIDALGO LCSW, LISW

II. Dates (important events)

Enumeration Date: 09/09/2015
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

731 SE ALICES RD # 1059
WAUKEE IA
50263-9646
US

IV. Provider business mailing address

731 SE ALICES RD # 1059
WAUKEE IA
50263-9646
US

V. Phone/Fax

Practice location:
  • Phone: 515-423-0345
  • Fax:
Mailing address:
  • Phone: 515-423-0345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW.09925244
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number077647
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: