Lori Nicole Eaton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW- 31259 Issued in ID

Practice address

3709 N Locust Grove Rd Ste 100
Meridian, ID 83646-6450

Phone

(208) 571-7100

Fax

(208) 493-4331

NPI assigned

Jan 21, 2009

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1232496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1003054560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 N LOCUST GROVE RD STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466450",
            "telephone_number": "208-571-7100",
            "fax_number": "208-493-4331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3709 N LOCUST GROVE RD STE 100",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836466450",
            "telephone_number": "208-571-7100",
            "fax_number": "208-493-4331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EATON",
        "first_name": "LORI",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-21",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW 28083",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW- 31259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806968300",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "1041C0700X",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "20001460",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• East West DPC
• Chamagne Janae Eaton, CST
• Cody Ray Eaton, D.D.S.
• James Anthony Eaton, DDS
• Laura Eaton, NP-C
• Blair Eby, NP
• Echo Base Counseling
• Echos of Change Counseling, LLC
• Edge Medical LLC
• Edgewood Spring Creek Meridian, LLC

• Clinical Social Worker in Meridian, ID
• Providers in Meridian, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.