CHARLES DOUGLAS BRYAN NPI 1689315111

NPI Information

  • NPI: 1689315111
  • Provider Name: CHARLES DOUGLAS BRYAN
  • Classification: Social Worker - 1041C0700X
  • Specialization: Clinical
  • Entity Type: Individual
  • Address: 373 W HIGHWAY 39 STE 1
    BLACKFOOT, ID
    ZIP 83221
  • Phone: (208) 557-9450

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NPI Details

Charles Douglas Bryan is a clinical social worker in Blackfoot, ID. The provider is 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. Charles Douglas Bryan NPI is 1689315111. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

373 W HIGHWAY 39 STE 1
BLACKFOOT, ID
ZIP 83221-228
Phone: (208) 557-9450
Fax: (208) 561-7111

The enumeration date for this NPI number is 4/6/2022 and was last updated on 4/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11041C0700XSocial WorkerClinicalLMSW-27872IDAHOYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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