Glenn James Larock is a Clinical in Boise, Idaho. Glenn James Larock practices all healthcare services and medical treatments related to Clinical. The NPI Number for Glenn James Larock is 1194816884. The last update date is 2023-10-04.
Glenn James Larock's current location address is 100 E Idaho St, Boise, Idaho. You can contact this provider via phone number 2083812711 and fax number 2083814025. The mailing address for Glenn James Larock is 100 E Idaho St, Boise, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Glenn James Larock |
|---|---|
| Address | 100 E Idaho St, Boise, Idaho |
| Phone Number | 2083812711 |
| Fax Number | 2083814025 |
| Sole Proprietor | Y |
| Credentials | LICSW |
NPI Number Detail
| NPI Number | 1194816884 |
|---|---|
| Provider Enumeration Date | 2006-09-27 |
| Last Updated Date | 2023-10-04 |
Provider Mailing Address Detail
| Address | 100 E Idaho St |
|---|---|
| City | Boise |
| State | Idaho (ID) |
| Post Code | 837126267 |
| Phone Number | 2083812711 |
| Fax Number | 2083814025 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | 110763 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1063650 | MA | NHP PROVIDER NUMBER | |
| 416714 | MA | MAGELLAN PROVIDER NUMBER | |
| P08083 | MA | BCBS PROVIDER NUMBER |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Glenn James Larock by the Centers for Medicare & Medicaid Services?
The Glenn James Larock has been issued the NPI (National Provider Identifier) 1194816884, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Glenn James Larock?
The Glenn James Larock is situated at 100 E Idaho St, in the city of Boise, state of ID, with the zip code 837126267.
What is the Glenn James Larock's area of specialization and corresponding taxonomy classification?
The Glenn James Larock's specialty field is Clinical, and it falls under the taxonomy code 1041C0700X, which categorizes healthcare providers based on their specialties.
On what date did the Glenn James Larock receive its 1194816884 assignment from the Centers for Medicare & Medicaid Services?
The Glenn James Larock was assigned its 1194816884 by the Centers for Medicare & Medicaid Services on 2006-09-27.
When was the information related to Glenn James Larock most recently updated or refreshed?
The details pertaining to the Glenn James Larock, including its address, specialty, and other relevant information, were last updated or refreshed on 2023-10-04.