Tawna Gulbis, LMSW
Individual provider Active NPI Social Worker · Nampa, ID
NPI 1033797113 · NPPES record last updated Nov 3, 2021
Key facts
- NPI
- 1033797113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 39775 (ID)
- Practice address
- 228 S Holly St
Nampa, ID 83686-5104 - Phone
- (208) 606-0469
- NPI assigned
- Mar 31, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38775 | ID | MD | Social Worker |
| 39775 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promise Academy Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 38775 | ID | |
| Social Worker | 104100000X | 39775 | ID | Yes |
Addresses
Primary practice location
228 S Holly St
Nampa, ID 83686-5104
Mailing address
6243 N Buckley PL
Boise, ID 83713-1202
Phone (208) 577-7770
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 3, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.