MEDICARE: NATALIE MAZHAMBE DINECOLA MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669960043
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE MAZHAMBE DINECOLA MSW, LCSW

Provider Business Mailing Address
First Line	:	PO BOX 1060
Second Line	:
City	:	MARSHALL
State	:	AR
Zip	:	72650-1060
Country	:	US
Telephone Number	:	225-439-0713
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 HOSPITAL DR
Second Line	:
City	:	MOUNTAIN HOME
State	:	AR
Zip	:	72653-2900
Country	:	US
Telephone Number	:	870-701-0238
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/01/2018
Last Update Date	:	08/20/2021

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