MS. KATHY MATLOCK TIDWELL (NPI# 1083767131) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083767131 |
| Entity Type | Individual |
| Full Name | MS. KATHY MATLOCK TIDWELL |
| Credential | LCSW |
| Practice Address |
5999 W State St Ste B Boise ID 83703-3039 |
| Mailing Address |
7285 W Franklin Rd Boise ID 83709-0926 |
| Practice Telephone | 2088535095 |
| Practice Fax Number | 2088535125 |
| Mailing Telephone | 2088535095 |
| Mailing Fax Number | 2088535125 |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2019-09-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
LCSW 858 | ID | Behavioral Health & Social Service Providers |
| Street Address |
5999 W STATE ST STE B |
| City | BOISE |
| State | ID |
| Zip Code | 83703-3039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104378595 | Aubrey Nocito | Counselor | 5999 W State St Ste B, Boise, ID 83703-5059 | 2016-11-01 |
| 1215243548 | Kodi Catania Hirst | Social Worker | 5999 W State St Ste B, Boise, ID 83703-5059 | 2010-08-24 |
| 1730320631 | Susan Patricia Harrell | Marriage & Family Therapist | 5999 W State St Ste B, Boise, ID 83703-5059 | 2009-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386203974 | Dylan Roy | Chiropractor | 5632 W State Street, Boise, ID 83703 | 2019-06-07 |
| 1124476858 | Tidwell Social Work Services and Consulting, Inc. | Community/Behavioral Health | 5999 W. State St., Boise, ID 83703 | 2016-06-03 |
| 1801251244 | Rebecca Lynn Cushing | Massage Therapist | 5909 W. State St, Boise, ID 83703 | 2015-12-30 |
| 1790181675 | Malinda Poe | Counselor | 4440 W Taft St, Boise, ID 83703 | 2014-11-05 |
| 1689079469 | Ashley Harker | Massage Therapist | 5909 W. State St., Boise, ID 83703 | 2014-10-23 |
| 1770987844 | Brick House Recovery | Counselor | 3663 N Lakeharbor Ln, Boise, ID 83703 | 2014-10-17 |
| 1033512538 | Ryan Warburton | Physical Therapist | 2999 N Lakeshore Lane, Ste 120, Boise, ID 83703 | 2014-09-29 |
| 1710386008 | Suzanne Iannaccone | Social Worker | 4090 W State St Ste 221, Boise, ID 83703 | 2014-08-22 |
| 1588092464 | Becky L. Marks | Social Worker | 3858 N. Garden Center Way, Suite 204, Boise, ID 83703 | 2013-10-31 |
| 1700219169 | Pohley Richey | Dietitian, Registered | 6052 W State Street, Boise, ID 83703 | 2013-08-20 |
| Find all providers in zip 83703 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679171961 | Jill Michelle Chonody | Social Worker | 3134 S Waterbury Ln, Boise, ID 83706-5222 | 2020-10-09 |
| 1750999777 | Deanna Armenia Brent | Social Worker | 7450 W Althea Ct, Boise, ID 83709-1777 | 2020-07-15 |
| 1013533231 | Sylvia Oh | Social Worker | 2118 S Latah St, Boise, ID 83705-3947 | 2020-06-23 |
| 1417577412 | Stacey Titus Pllc | Social Worker | 5440 W Franklin Rd Ste 201, Boise, ID 83705-6434 | 2020-04-20 |
| 1447888656 | Berndt and Associates In Psychcare LLC | Social Worker | 4477 W Emerald St Ste C275, Boise, ID 83706-2078 | 2020-04-01 |
| 1528690773 | Marc Adrian Dominguez | Social Worker | 1299 N Orchard St Ste 110, Boise, ID 83706-2266 | 2020-02-06 |
| 1235774407 | Wildflower Intuitive Center, LLC | Social Worker | 4696 W Overland Rd Ste 276, Boise, ID 83705-2877 | 2019-11-12 |
| 1558903328 | Daring In Idaho, LLC | Social Worker | 413 N Allumbaugh Street, Suite 102, Boise, ID 83704 | 2019-10-14 |
| 1821550203 | Alturas Counseling | Social Worker | 204 S Cole Rd, Boise, ID 83709-0934 | 2019-04-03 |
| 1750859856 | Jani Lynn Belcoe | Social Worker | 3029 N 32nd St, Boise, ID 83703-5001 | 2018-11-06 |
| Find all providers in BOISE | ||||
Please comment or provide details below to improve the information on MS. KATHY MATLOCK TIDWELL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.