| Tidwell Social Work Services & Consulting | |
|
5999 W State St Boise ID 83703-5059 | |
| (208) 853-5095 | |
| (208) 853-5125 |
| Full Name | Tidwell Social Work Services & Consulting |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 5999 W State St, Boise, Idaho |
| Authorized Official Name and Position | Kathy Tidwell (OWNER) |
| Authorized Official Contact | 2088535095 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidwell Social Work Services & Consulting 5999 W State St Boise ID 83703-5059 Ph: (208) 853-5095 | Tidwell Social Work Services & Consulting 5999 W State St Boise ID 83703-5059 Ph: (208) 853-5095 |
| NPI Number | 1669401311 |
|---|---|
| Provider Enumeration Date | 07/02/2006 |
| Last Update Date | 06/16/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669401311 | NPI | - | NPPES |
| 806014000 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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