Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KENRIC GLENN GORDON, LMSW
ActiveKENRIC GLENN GORDON, LMSW is a Social Worker healthcare provider located in CHUBBUCK, Idaho. NPI 1114540804 is currently active in the NPPES registry. Verify at CMS.
Social Worker · CHUBBUCK, ID
Registration Details
- NPI Number
- 1114540804
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 28, 2020 (6.2046520170976 yrs)
- Last Updated
- May 28, 2020
- License
-
LMSW-39661 (ID)
Practice Information
- Address
-
210 W BURNSIDE AVE STE ACHUBBUCK, ID, 832024916Browse ID providers · Browse ZIP 83202
- Phone
- 2082389000
- Primary Specialty
-
Social Worker
104100000X
Other Social Worker Providers in CHUBBUCK, ID
| Name | Credential | NPI |
|---|---|---|
| AMANDA JILL SIEMS | L.S.W | 1689871089 |
| PAULETTE TOLEDO | — | 1255604401 |
| STARALEE BAIRD | LMSW | 1013344696 |
| MR. DANIEL M KNAPP | LMSW | 1750718227 |
| JANIE DAWN MARLEY | LMSW | 1629450002 |
| ASHLYNN HAYDEN OBORN | LMSW | 1083238877 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.