Glenda K Thomson, LCSW | |
2235 E 25th St, Suite 290, Idaho Falls, ID 83404-7519 | |
(208) 552-0490 | |
(208) 552-2518 |
Full Name | Glenda K Thomson |
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Gender | Female |
Speciality | Social Worker - Clinical |
Location | 2235 E 25th St, Idaho Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1063738359 | NPI | - | NPPES |
806472900 | Medicaid | ID |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW-21529 (Arizona) | Secondary |
1041C0700X | Social Worker - Clinical | LCSW30186 (Idaho) | Primary |
Entity Name | Mountain Park Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1558308825 PECOS PAC ID: 8325949647 Enrollment ID: O20040119000460 |
Mailing Address | Practice Location Address |
---|---|
Glenda K Thomson, LCSW 2235 E 25th St, Suite 290, Idaho Falls, ID 83404-7519 Ph: (208) 552-0490 | Glenda K Thomson, LCSW 2235 E 25th St, Suite 290, Idaho Falls, ID 83404-7519 Ph: (208) 552-0490 |
Corene Peterson, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1565 E Lincoln Rd, Idaho Falls, ID 83401 Phone: 208-524-8996 Fax: 208-524-1205 | |
Daniel James Griffin, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1070 Riverwalk Dr Ste 258, Idaho Falls, ID 83402 Phone: 208-219-7655 | |
Mr. Nathan R Porter, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 100 N Woodruff Ave, Idaho Falls, ID 83401 Phone: 208-346-2363 | |
Travis Aaron Dean, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1337 E 17th St, Idaho Falls, ID 83404 Phone: 208-525-2090 Fax: 208-523-8978 | |
Mr. Claigh H Jensen, MSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1600 John Adams Pkwy, Suite 102, Idaho Falls, ID 83401 Phone: 208-529-5276 Fax: 208-529-6506 | |
Jessica Marley, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2420 E 25th St, Idaho Falls, ID 83404 Phone: 208-542-1026 Fax: 208-528-2945 | |
Marcus Boyd Golder, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2275 W Broadway St Ste G, Idaho Falls, ID 83402 Phone: 208-524-7400 Fax: 208-524-8004 |