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

Jonathan Thacker

Individual provider Clinical Social Worker · NPI 1629841952

Jonathan Thacker is a Clinical Social Worker in Preston, Idaho. Practices as a sole proprietor. Licensed in Idaho.

Licensed in
ID
In the registry since
2023
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Practice location Address checks out

75 S 1st W
Preston, ID 83263-1204
Phone: (208) 852-2370
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LMSW-44232 (ID)

Record details

NPI number1629841952
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 30, 2023
Last updated in NPPESOctober 30, 2023
Certification dateOctober 30, 2023
Mailing address1327 N 25 E, Layton, UT 84041-2977

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