Provider Demographics
NPI:1851031397
Name:BESETTE, NICKY (LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:NICKY
Middle Name:
Last Name:BESETTE
Suffix:
Gender:
Credentials:LCSW, LICSW
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 33
Mailing Address - Street 2:
Mailing Address - City:ABERCROMBIE
Mailing Address - State:ND
Mailing Address - Zip Code:58001-0033
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:500 DAKOTA AVE STE 106
Practice Address - Street 2:
Practice Address - City:WAHPETON
Practice Address - State:ND
Practice Address - Zip Code:58075-4444
Practice Address - Country:US
Practice Address - Phone:017-730-4395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-31
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND48491041C0700X
MN243051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND6874OtherND BOARD OF SOCIAL WORK
MN24305OtherMN BOARD OF SOCIAL WORK