Provider Demographics
NPI:1821218264
Name:KOVIS-TONKS, DOREE ERIKA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DOREE
Middle Name:ERIKA
Last Name:KOVIS-TONKS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:DOREE
Other - Middle Name:ERIKA
Other - Last Name:KOVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:5146 NORTH TURRET WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83703
Mailing Address - Country:US
Mailing Address - Phone:208-610-2061
Mailing Address - Fax:
Practice Address - Street 1:1627 SOUTH ORCHARD
Practice Address - Street 2:SUITE 140
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705
Practice Address - Country:US
Practice Address - Phone:208-610-2061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLMSW-31016101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA44CFOtherMEDI-CAL PRV NBR
CA27BW8OtherMEDI-CAL PRV NBR
CAD8360099OtherDRIVER'S LICENSE