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DAN TADLOCK LCSW
NPI 1124397476
Social Worker - Clinical in Bonners Ferry, ID

Active since December 15, 2011PECOS EnrolledAccepts Medicare Assignment
6426 KOOTENAI STREET, SUITE 103, BONNERS FERRY, ID 83805(208) 291-1516 Get Directions Write a Review

NPPES record last updated: March 27, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 27, 2026, Nov 7, 2025 (2 updates tracked since 2025).

About Dan Tadlock Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAN TADLOCK LCSW (NPI 1124397476) is an individual clinical provider in Bonners Ferry, Idaho, licensed in Idaho (LCSW-29379) and active in the NPI registry since December 2011. He is enrolled in Medicare PECOS, maintains a secondary practice location in Boise, and is a graduate of Other (2004).

NPPES Registry Identity

NPI1124397476
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameDAN TADLOCKCredential: LCSW
Location Address6426 KOOTENAI STREET, SUITE 103Bonners Ferry, ID 83805-5005
Mailing AddressPo Box 1014Bonners Ferry, ID 83805-1014 · (208) 255-9460
Phone(208) 291-1516
Sole ProprietorNo
Medical School CMSOtherGraduated 2004
Enumeration DateDecember 15, 2011
Last NPPES UpdateMarch 27, 20262 updates tracked since enumeration
NPPES CertifiedMarch 27, 2026
✔ NPI 1124397476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in ID · LCSW-29379
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, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
6426 KOOTENAI STREET, SUITE 103, Bonners Ferry, ID 83805
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Secondary Practice Location 1

Location 14750 N Five Mile RdBoise, ID 83713-2715 · Phone (888) 949-4864

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dan Tadlock Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2264804616
PECOS Enrollment IDI20230210001272
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83805 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $52.44 – $160.17
Typical copayment $0.00 (range $13.11 – $40.04)
Most-billed visit code NA
Established Patient
$65.77 typical visit price
range $16.68 – $130.93
Typical copayment $16.44 (range $4.17 – $32.73)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dan Tadlock's NPI number?

The NPI number for Dan Tadlock is 1124397476. It was assigned to this individual provider in the NPPES registry on December 15, 2011.

Where is Dan Tadlock located?

Dan Tadlock practices at 6426 Kootenai Street, Suite 103, Bonners Ferry, ID 83805. The listed phone number is (208) 291-1516.

What is Dan Tadlock's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Dan Tadlock enrolled in Medicare?

Yes. Dan Tadlock is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Dan Tadlock was last updated on March 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.