Provider Demographics
NPI:1285907790
Name:ABRAHAMSON, ACACIA DANIELLE (LCSW)
Entity type:Individual
Prefix:
First Name:ACACIA
Middle Name:DANIELLE
Last Name:ABRAHAMSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ACACIA
Other - Middle Name:DANIELLE
Other - Last Name:HEFFNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 4673
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59604-4673
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:44 N LAST CHANCE GULCH STE 6
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4158
Practice Address - Country:US
Practice Address - Phone:406-220-6266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2022-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 372600000X
MT451031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT45103OtherSTATE LICENSE