Provider Demographics
NPI:1982149589
Name:CARDIN, TODD (MSW, LCSW, LAC)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:
Last Name:CARDIN
Suffix:
Gender:M
Credentials:MSW, LCSW, LAC
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 2226
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59903-2226
Mailing Address - Country:US
Mailing Address - Phone:406-250-3960
Mailing Address - Fax:
Practice Address - Street 1:1103 S MAIN ST
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-5674
Practice Address - Country:US
Practice Address - Phone:406-250-3960
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-05
Last Update Date:2021-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLAC-LAC-LIC-868101YA0400X
MT197601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)