Provider Demographics
NPI:1679381040
Name:NOLF, DENNIS TIMOTHY (CSW)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:TIMOTHY
Last Name:NOLF
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:543 WESTWIND RD
Mailing Address - Street 2:
Mailing Address - City:BOX ELDER
Mailing Address - State:SD
Mailing Address - Zip Code:57719-9730
Mailing Address - Country:US
Mailing Address - Phone:231-715-9176
Mailing Address - Fax:
Practice Address - Street 1:224 ELK ST
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7359
Practice Address - Country:US
Practice Address - Phone:231-715-9176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-18
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD6533104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker