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CHARLES DOUGLAS BRYAN
NPI 1689315111
Social Worker - Clinical in Blackfoot, ID

Active since April 06, 2022
373 W HIGHWAY 39 STE 1, BLACKFOOT, ID 83221(208) 557-9450(208) 561-7111 Get Directions Write a Review

NPPES record last updated: April 6, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Charles Douglas Bryan NPPES

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

CHARLES DOUGLAS BRYAN (NPI 1689315111) is an individual clinical provider in Blackfoot, Idaho, licensed in Idaho (LMSW-27872) and active in the NPI registry since April 2022.

NPPES Registry Identity

NPI1689315111
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameCHARLES DOUGLAS BRYAN
Location Address373 W HIGHWAY 39 STE 1Blackfoot, ID 83221-5228
Mailing Address444 Hospital Way Ste 422Pocatello, ID 83201-2744 · (208) 557-9450 · Fax (208) 561-7111
Phone(208) 557-9450
Fax(208) 561-7111
Sole ProprietorNo
Enumeration DateApril 6, 2022
NPPES CertifiedApril 6, 2022
✔ NPI 1689315111 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 · LMSW-27872
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.
373 W HIGHWAY 39 STE 1, Blackfoot, ID 83221
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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 Charles Bryan's NPI number?

The NPI number for Charles Bryan is 1689315111. It was assigned to this individual provider in the NPPES registry on April 6, 2022.

Where is Charles Bryan located?

Charles Bryan practices at 373 W Highway 39 Ste 1, Blackfoot, ID 83221. The listed phone number is (208) 557-9450.

What is Charles Bryan's specialty?

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

When was this NPI record last updated?

The NPPES record for Charles Bryan was last updated on April 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.