Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Charles Douglas Bryan

Individual provider Clinical Social Worker · NPI 1689315111

Charles Douglas Bryan is a Clinical Social Worker in Blackfoot, Idaho. Licensed in Idaho. Registered with an NPI since 2022.

Licensed in
ID
In the registry since
2022

Practice location Address checks out

373 W Highway 39 Ste 1
Blackfoot, ID 83221-5228
Phone: (208) 557-9450
Fax: (208) 561-7111
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LMSW-27872 (ID)

Record details

NPI number1689315111
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 6, 2022
Last updated in NPPESApril 6, 2022
Certification dateApril 6, 2022
Mailing address444 Hospital Way Ste 422, Pocatello, ID 83201-2744

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