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NPI Code Detail

MEDICARE: ROBERT EDWARD HADLEY LMSW

MEDICARE: ROBERT EDWARD HADLEY LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLCSW-39797ID

General Provider Information

NPI Number : 1639666811
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT EDWARD HADLEY LMSW
Provider Business Mailing Address
First Line : 217 W GEORGIA AVE STE 120
Second Line :
City : NAMPA
State : ID
Zip : 83686-6812
Country : US
Telephone Number : 208-498-1760
Fax Number : 208-498-1769
Provider Business Practice Location Address
First Line : 217 W GEORGIA AVE STE 120
Second Line :
City : NAMPA
State : ID
Zip : 83686-6812
Country : US
Telephone Number : 208-498-1760
Fax Number : 208-498-1769
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2018
Last Update Date : 04/22/2021

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Directions to “ ROBERT EDWARD HADLEY LMSW” Practice Location

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