Mary Kay Gordon-brunner, | |
314 Badiola St, Caldwell, ID 83605-4389 | |
(702) 589-4871 | |
Not Available |
Full Name | Mary Kay Gordon-brunner |
---|---|
Gender | Female |
Speciality | Social Worker - Clinical |
Location | 314 Badiola St, Caldwell, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003593914 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW-33403 (Idaho) | Primary |
Entity Name | Human Supports Of Idaho |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1922340124 PECOS PAC ID: 0244485894 Enrollment ID: O20130305000118 |
Entity Name | Totius Therapies Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083126023 PECOS PAC ID: 3971963299 Enrollment ID: O20230719000001 |
Mailing Address | Practice Location Address |
---|---|
Mary Kay Gordon-brunner, Po Box 264, Middleton, ID 83644-0264 Ph: () - | Mary Kay Gordon-brunner, 314 Badiola St, Caldwell, ID 83605-4389 Ph: (702) 589-4871 |
Mrs. Kristina Marie Pugh, MSW, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 13802 Quintessa St, Caldwell, ID 83607 Phone: 801-599-7123 | |
Tara Byrne, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3402 Franklin Rd, Caldwell, ID 83605 Phone: 208-608-8839 | |
Mrs. Amanda Kay Goldston, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3402 Franklin Rd, Caldwell, ID 83605 Phone: 208-455-7045 Fax: 208-454-7714 | |
Judy Ann Hudson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 23057 Old Highway 30, Caldwell, ID 83607 Phone: 208-860-2345 Fax: 208-459-6921 | |
Ms. Asha Sharp, LMSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3402 Franklin Rd, Caldwell, ID 83605 Phone: 208-455-7033 Fax: 208-454-7714 | |
Jason Johnson, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 2609 S 10th Ave Ste 102, Caldwell, ID 83605 Phone: 208-454-2766 |