Healthcare Provider Details

I. General information

NPI: 1588598775
Provider Name (Legal Business Name): DANIEL R HEALD MSWL 1581610
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 MAIN ST STE 3B
SALMON ID
83467-4452
US

IV. Provider business mailing address

1301 MAIN ST STE 3B
SALMON ID
83467-4452
US

V. Phone/Fax

Practice location:
  • Phone: 208-756-2927
  • Fax: 208-756-1518
Mailing address:
  • Phone: 208-756-2927
  • Fax: 208-756-1518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number1581610
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: