| Dan Tadlock, LCSW | |
|
6883 Fresno St, Bonners Ferry, ID 83805-8556 | |
| (208) 946-7005 | |
| Not Available |
| Full Name | Dan Tadlock |
|---|---|
| Gender | Male |
| Speciality | Social Worker - Clinical |
| Location | 6883 Fresno St, Bonners Ferry, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124397476 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-29379 (Idaho) | Primary |
| Entity Name | Kootenai Tribe Of Idaho |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1669594057 PECOS PAC ID: 7315184926 Enrollment ID: O20130517000477 |
| Mailing Address | Practice Location Address |
|---|---|
| Dan Tadlock, LCSW 6883 Fresno St, Bonners Ferry, ID 83805-8556 Ph: (208) 946-7005 | Dan Tadlock, LCSW 6883 Fresno St, Bonners Ferry, ID 83805-8556 Ph: (208) 946-7005 |
Kimberly Ruth Carey, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 6451 Mccall St Ste D, Bonners Ferry, ID 83805 Phone: 208-520-7155 | |
Gina M. Beck, L.C.S.W. Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 6451 Mccall St Ste D, Bonners Ferry, ID 83805 Phone: 208-304-2657 Fax: 208-215-2473 | |
Robert Rossi, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: Kaniksu Health Services, 6615 Comanche St, Bonners Ferry, ID 83805 Phone: 612-343-4215 | |
Barbara Hinderlie, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 6807 Cody St, Bonners Ferry, ID 83805 Phone: 208-267-0900 | |
Jeanne B Racer, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 147 Emerson Ln, Bonners Ferry, ID 83805 Phone: 208-267-7522 | |
Rachel Meiland-webster, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: Po Box 3068, Room 200, Bonners Ferry, ID 83805 Phone: 208-267-8182 |