| Mrs Tracey Lynn White, LCSW | |
|
2290 W Prairie Ave, Coeur D Alene, ID 83815-8424 | |
| (207) 772-7994 | |
| (208) 772-5916 |
| Full Name | Mrs Tracey Lynn White |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 2290 W Prairie Ave, Coeur D Alene, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134555782 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1234 (Alaska) | Secondary |
| 1041C0700X | Social Worker - Clinical | 38434 (Idaho) | Primary |
| Entity Name | Hospice Of North Idaho Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1245235878 PECOS PAC ID: 9931299336 Enrollment ID: O20071224000032 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Tracey Lynn White, LCSW 2290 W Prairie Ave, Coeur D Alene, ID 83815-8424 Ph: (208) 772-7994 | Mrs Tracey Lynn White, LCSW 2290 W Prairie Ave, Coeur D Alene, ID 83815-8424 Ph: (207) 772-7994 |
Donna Colberg, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6050 E Kingswood Ln, Coeur D Alene, ID 83814 Phone: 208-651-3948 | |
Deemarla Tavares, LMSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3700 W Seltice Way, Coeur D Alene, ID 83814 Phone: 208-620-5250 | |
Ms. Erica Marie Chaney I, LSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3700 W Seltice Way, Coeur D Alene, ID 83814 Phone: 208-620-5250 | |
Mr. Jud Eugene Leifheit, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1110 W Park Pl Ste 305, Coeur D Alene, ID 83814 Phone: 208-667-6606 Fax: 208-765-3051 | |
Wayne Bingham Timonen, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 7905 N Meadowlark Way, Suite C, Coeur D Alene, ID 83815 Phone: 208-762-3979 Fax: 208-762-4419 | |
Robert K Wyatt, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1111 W Ironwood Dr Ste B, Coeur D Alene, ID 83814 Phone: 208-664-1594 Fax: 208-664-5867 | |
Laurie D Regan, LCSW 688 Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Phone: 208-666-2000 Fax: 208-666-3963 |