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General NPI Number Information
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NPI Number | 1831686211
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Entity Type | Individual
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Provider Name | ANGELA DAWN BARTLOW LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 06/03/2025
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Provider Practice Location Address
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Address Line | 1015 CALDWELL BLVD
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City | NAMPA
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State | ID
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Zip | 83651-1717
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Country | US
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Telephone | 208-994-3811
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Fax |
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Provider Business Mailing Address
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Address Line | 1015 CALDWELL BLVD
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City | NAMPA
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State | ID
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Zip | 83651-1717
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Country | US
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Telephone | 208-994-3811
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 33020
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW42435
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License Number State | ID
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