Terry Shake, is a
Social Worker based in Boise, Idaho. Terry Shake is licensed to practice in Idaho (license number 33482) and his current practice location is
9196 W Barnes Dr, Boise, Idaho. He can be reached at his office (for appointments etc.) via phone at
(208) 433-0400.
NPI number for Terry Shake is 1538791181 and his current mailing address is 7239 W Modoc St, Boise, Idaho. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1538791181.
Healthcare Provider's Profile
| Full Name | Terry Shake |
|---|
| Gender | Male |
|---|
| Speciality | Social Worker |
|---|
| Location | 9196 W Barnes Dr, Boise, Idaho |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1538791181
- Provider Enumeration Date: 02/11/2020
- Last Update Date: 02/11/2020
Medical Identifiers
Medical identifiers for Terry Shake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538791181 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 11416 (Idaho) | Secondary |
| 104100000X | Social Worker | 33482 (Idaho) | Primary |
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. Terry Shake 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 |
|---|
Terry Shake,
7239 W Modoc St,
Boise, ID 83709-6158
Ph: (208) 954-7383 | Terry Shake,
9196 W Barnes Dr,
Boise, ID 83709-1552
Ph: (208) 433-0400 |
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