Search › Idaho › 1041C0700X
Dan Tadlock, LCSW
NPI 1124397476 · on the registry since 2011
Practice
- Address
- 6426 Kootenai Street, Suite 103
Bonners Ferry, ID 83805 - Phone
- (208) 291-1516
- Clinicians at this address
- 2
Additional practice sites
- 4750 N Five Mile Rd, Boise, ID
Registry record
- Primary taxonomy
- 1041C0700X
1041C0700X
- Licence states on file
- ID
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-03-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Idaho