Provider Demographics
NPI:1609127430
Name:NIEHAUS, DELORES LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:DELORES
Middle Name:LYNN
Last Name:NIEHAUS
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31001-4110
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91110-4110
Mailing Address - Country:US
Mailing Address - Phone:406-327-3362
Mailing Address - Fax:406-327-3349
Practice Address - Street 1:900 N ORANGE ST STE 202
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59802-2951
Practice Address - Country:US
Practice Address - Phone:406-327-3362
Practice Address - Fax:406-327-3349
Is Sole Proprietor?:No
Enumeration Date:2012-09-19
Last Update Date:2025-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN101YS0200X
IN34007472A1041C0700X
MTBBH-LCSW-LIC-726451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool