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

Dan Tadlock, LCSW

Individual provider Clinical Social Worker · NPI 1124397476

Dan Tadlock, LCSW is a Clinical Social Worker in Bonners Ferry, Idaho. Qualified in 2004, 22 years ago. Works from 2 locations and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
22
Licensed in
ID
In the registry since
2011
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

6426 Kootenai St Ste 103
Bonners Ferry, ID 83805-5005
Phone: (208) 291-1516
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

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

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-29379 (ID)

Record details

NPI number1124397476
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorNo
NPI enumeratedDecember 15, 2011
Last updated in NPPESMarch 27, 2026
Certification dateMarch 27, 2026
Mailing addressPo Box 1014, Bonners Ferry, ID 83805-1014

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bonners Ferry