Individual provider · Type 1 NPI

Mandy Fernandez, LCSW

Clinical Social Worker · Pocatello, ID

NPI number 1407459258 Active

Practice location

1777 E Clark St Ste 330
Pocatello, ID 83201-3357

Call (208) 478-9081 Map

Mailing address

195 Charles Pl
Pocatello, ID 83201-3248

Specialties and licenses

TaxonomyCodeLicense
Social Worker 104100000XLMSW-39280 (ID)
Clinical Social Worker Primary 1041C0700X8861300 (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 1407459258

Mandy Fernandez, LCSW's National Provider Identifier is 1407459258, issued on Nov 16, 2020. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Pocatello, ID. The record was last updated on Nov 12, 2024.