David A. Teed, Cswp, Pa | |
3350 W Americana Ter Ste 310b Boise ID 83706-2548 | |
(208) 484-1446 | |
(208) 514-1534 |
Full Name | David A. Teed, Cswp, Pa |
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Speciality | Clinic/Center |
Location | 3350 W Americana Ter Ste 310b, Boise, Idaho |
Authorized Official Name and Position | David Anthony Teed (PRESIDENT) |
Authorized Official Contact | 2084841446 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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David A. Teed, Cswp, Pa 3350 W Americana Ter Ste 310b Boise ID 83706-2548 Ph: (208) 484-1446 | David A. Teed, Cswp, Pa 3350 W Americana Ter Ste 310b Boise ID 83706-2548 Ph: (208) 484-1446 |
NPI Number | 1487370052 |
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Provider Enumeration Date | 10/17/2022 |
Last Update Date | 10/17/2022 |
Certification Date | 10/16/2022 |
Medicare PECOS PAC ID | 3173992930 |
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Medicare Enrollment ID | O20221217000271 |
Identifier | Type | State | Issuer |
---|---|---|---|
1487370052 | NPI | - | NPPES |
LCSW-1031 | Other | ID | STATE LICENSURE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
Provider Name | David A Teed |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1437261401 PECOS PAC ID: 3375597065 Enrollment ID: I20050304000787 |
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