Tyler Dawn Moulton, LCSW is a
Social Worker - Clinical based in Gooding, Idaho. Tyler Dawn Moulton is licensed to practice in Idaho (license number 8911494) and her current practice location is
605 11th Ave E, Gooding, Idaho. She can be reached at her office (for appointments etc.) via phone at
(208) 934-8461.
NPI number for Tyler Dawn Moulton is 1710739750 and her current mailing address is 605 11th Ave E, Gooding, Idaho. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1710739750.
Healthcare Provider's Profile
| Full Name | Tyler Dawn Moulton |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
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| Location | 605 11th Ave E, Gooding, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1710739750
- Provider Enumeration Date: 04/03/2024
- Last Update Date: 06/19/2026
Medical Identifiers
Medical identifiers for Tyler Dawn Moulton such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1710739750 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1041C0700X | Social Worker - Clinical | 8911494 (Idaho) | Primary |
| 104100000X | Social Worker | LMSW-44450 (Idaho) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tyler Dawn Moulton is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Tyler Dawn Moulton, LCSW 605 11th Ave E, Gooding, ID 83330-5368 Ph: (208) 934-8461 | Tyler Dawn Moulton, LCSW 605 11th Ave E, Gooding, ID 83330-5368 Ph: (208) 934-8461 |
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