| Tidwell Social Work Services And Consulting | |
|
5999 W. State St. Boise ID 83703 | |
| (208) 853-5095 | |
| (208) 853-5125 |
| Full Name | Tidwell Social Work Services And Consulting |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5999 W. State St., Boise, Idaho |
| Authorized Official Name and Position | Kathy Matlock Tidwell (CLINIC SUPERVISOR) |
| Authorized Official Contact | 2088536649 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidwell Social Work Services And Consulting 7285 W Franklin Rd Boise ID 83709-0926 Ph: (208) 853-5095 | Tidwell Social Work Services And Consulting 5999 W. State St. Boise ID 83703 Ph: (208) 853-5095 |
| NPI Number | 1124476858 |
|---|---|
| Provider Enumeration Date | 06/03/2016 |
| Last Update Date | 09/16/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124476858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | LPC-6143 (Idaho) | Primary |
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