Individual provider · Type 1 NPI

Dan Tadlock, LCSW

Clinical Social Worker · Bonners Ferry, ID

NPI number 1124397476 Active

Practice location

6426 Kootenai Street, Suite 103
Bonners Ferry, ID 83805-5005

Mailing address

PO Box 1014
Bonners Ferry, ID 83805-1014

Other practice locations

  • 4750 N Five Mile Rd, Boise, ID 83713-2715 · (888) 949-4864

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700XLCSW-29379 (ID)

Clinical Social Worker: 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 interpers…

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About NPI 1124397476

Dan Tadlock, LCSW's National Provider Identifier is 1124397476, issued on Dec 15, 2011. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Bonners Ferry, ID. The record was last updated on Mar 27, 2026.