MEDICARE: MRS. DOREE ERIKA KOVIS-TONKS LCSW

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
1	101YM0800X	Mental Health Counselor	LMSW-31016	ID

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	44CF	OTHER	CA	MEDI-CAL PRV NBR
2	27BW8	OTHER	CA	MEDI-CAL PRV NBR
3	D8360099	OTHER	CA	DRIVER'S LICENSE

General Provider Information

NPI Number	:	1821218264
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DOREE ERIKA KOVIS-TONKS LCSW

Provider Business Mailing Address
First Line	:	5146 NORTH TURRET WAY
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83703
Country	:	US
Telephone Number	:	208-610-2061
Fax Number	:

Provider Business Practice Location Address
First Line	:	1627 SOUTH ORCHARD
Second Line	:	SUITE 140
City	:	BOISE
State	:	ID
Zip	:	83705
Country	:	US
Telephone Number	:	208-610-2061
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2007
Last Update Date	:	10/28/2016

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Directions to “ MRS. DOREE ERIKA KOVIS-TONKS LCSW” Practice Location

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