Provider Demographics
NPI:1396706396
Name:ATKINSON, IRMA CALNON (MSW)
Entity type:Individual
Prefix:MS
First Name:IRMA
Middle Name:CALNON
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5418 N EAGLE RD
Mailing Address - Street 2:STE 180
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713
Mailing Address - Country:US
Mailing Address - Phone:208-938-3837
Mailing Address - Fax:208-938-3857
Practice Address - Street 1:5418 N EAGLE RD
Practice Address - Street 2:STE 180
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713
Practice Address - Country:US
Practice Address - Phone:208-938-3837
Practice Address - Fax:208-938-3857
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW6441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical