Mr Mathew G Bowden, CSW | |
1309 Bennett Ave, Burley, ID 83318-2676 | |
(208) 678-0101 | |
Not Available |
Full Name | Mr Mathew G Bowden |
---|---|
Gender | Male |
Speciality | Social Worker - Clinical |
Location | 1309 Bennett Ave, Burley, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1215194121 | NPI | - | NPPES |
260022408 | Other | UT | RAILROAD MEDICARE |
876000308007 | Medicaid | UT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | LCSW-38761 (Idaho) | Primary |
1041C0700X | Social Worker - Clinical | 70059863502 (Utah) | Secondary |
Entity Name | Weber Human Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1043243140 PECOS PAC ID: 3274430244 Enrollment ID: O20031217000665 |
Mailing Address | Practice Location Address |
---|---|
Mr Mathew G Bowden, CSW 794 Eastland Dr, Twin Falls, ID 83301-6856 Ph: (208) 737-6718 | Mr Mathew G Bowden, CSW 1309 Bennett Ave, Burley, ID 83318-2676 Ph: (208) 678-0101 |
Gina Bosco, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2300 Overland Ave, Burley, ID 83318 Phone: 208-732-8565 Fax: 208-732-8566 | |
Jordan K. Robins, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 1309 Bennett Ave, Burley, ID 83318 Phone: 208-678-0101 Fax: 208-678-0303 | |
Tamara Wilkinson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1320 Bennett Ave # B, Burley, ID 83318 Phone: 208-678-0101 Fax: 208-678-0303 |