Organization
TIDWELL SOCIAL WORK SERVICES AND CONSULTING, INC.
Active
Other names
Tidwell Social Work Services and Consulting
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY MATLOCK TIDWELL LCSW (CLINIC SUPERVISOR)
(208) 853-6649
Entity
Organization
Contact information
Practice address
5999 W. STATE ST., BOISE, ID 83703
(208) 853-5095
(208) 853-5125
Mailing address
7285 W FRANKLIN RD, BOISE, ID 83709-0926
(208) 853-5095
(208) 853-5125
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
LPC-6143
ID
Other
Enumeration date
06/03/2016
Last updated
09/16/2019
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