person
Mr. Michael Shane Oldfield I, LMSW
Mental Health Counselor in Idaho Falls, Idaho
NPI 1174756290

Michael Shane Oldfield I is a Mental Health Counselor based in Idaho Falls, ID and is specialized in Mental Health. Michael Shane Oldfield I practices in Idaho Falls, ID and has the professional credentials of LMSW. The NPI Number for Michael Shane Oldfield I is 1174756290 and holds a License No. 29470 (Idaho).

The current practice location address for Michael Shane Oldfield I is 2420 E 25Th St, Idaho Falls, ID and can be reached out via phone at 208-542-1026.

Location: 2420 E 25Th St, Idaho Falls, ID, 83404-7549
person
Provider Profile Details
NPI Number
1174756290
Provider Name
Michael Shane Oldfield I
Credential
LMSW
Provider Entity Type
Individual
Gender
Male
Address
2420 E 25Th St, Idaho Falls, ID, 83404-7549
Phone Number
208-542-1026
Fax Number
Provider Enumeration Date
08/24/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
29470 01 ID MASTERS OF SOCIAL WORKER IDAHO STATE LICENSE NUMBER (LMSW)
institution
Provider Business Practice Location Address Details
Address
2420 E 25Th St
City
State
Zip
83404-7549
Phone Number
208-542-1026
Fax Number
person
Provider Business Mailing Address Details
Address
2420 E 25Th St
City
State
Zip
83404-7549
Phone Number
208-542-1026
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
License No.
29470 (Idaho)
Definition
Definition to come...
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