Healthcare Provider Details

I. General information

NPI: 1629270905
Provider Name (Legal Business Name): DAYNEN JEAN LALICKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 10/03/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2227 FLORENCE AVE
BUTTE MT
59701-6032
US

IV. Provider business mailing address

2227 FLORENCE AVE
BUTTE MT
59701-6032
US

V. Phone/Fax

Practice location:
  • Phone: 406-299-3637
  • Fax: 406-299-3638
Mailing address:
  • Phone: 406-299-3637
  • Fax: 406-299-3638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5323-LCSW
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number5671
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: