| Jennifer Rian Tuttle, LCSW | |
|
9705 N Shaw St, Hayden, ID 83835-9716 | |
| (208) 625-9981 | |
| Not Available |
| Full Name | Jennifer Rian Tuttle |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 9705 N Shaw St, Hayden, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609158781 | NPI | - | NPPES |
| 1609158781 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | LCSW-31649 (Idaho) | Secondary |
| 1041C0700X | Social Worker - Clinical | 31649 (Idaho) | Primary |
| Entity Name | Lake City Counseling Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1720513963 PECOS PAC ID: 3779904503 Enrollment ID: O20200819001200 |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Rian Tuttle, LCSW 9705 N Shaw St, Hayden, ID 83835-9716 Ph: (208) 625-9981 | Jennifer Rian Tuttle, LCSW 9705 N Shaw St, Hayden, ID 83835-9716 Ph: (208) 625-9981 |
Dr. Kateri Picard Ray, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1302 W Starling Ave, Hayden, ID 83835 Phone: 208-640-8814 | |
Nicole Joy Vatterrodt, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13403 N Government Way Ste 319, Hayden, ID 83835 Phone: 480-980-5703 | |
Sarah E Hlebichuk, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 21 W Commerce Dr Ste F, Hayden, ID 83835 Phone: 208-704-0046 | |
Cristy Kay, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 9494 N Government Way # 202, Hayden, ID 83835 Phone: 208-315-9321 | |
Ms. Terri Lynn Sudol, M.S.W., L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 10615 N Government Way Ste 206, Hayden, ID 83835 Phone: 208-755-5188 Fax: 208-772-2533 | |
Courtney Breann Jepson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8152 N Wayne Drive, Hayden, ID 83835 Phone: 208-691-5063 | |
Mrs. Lindsey Nichole Petrick, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13403 N Government Way Ste 319, Hayden, ID 83835 Phone: 208-755-1641 |