Miranda Arisbet Hernandez

Individual provider Active NPI Clinical Social Worker · Payette, ID

NPI 1003481763 · NPPES record last updated Jul 6, 2026

Key facts

NPI
1003481763
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
LCSW-45303 (ID)
Practice address
250 S Main St
Payette, ID 83661-2853
Phone
(208) 406-4245
NPI assigned
May 25, 2021
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
LMSW-40800IDMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW-40800 ID
Clinical Social Worker 1041C0700X LCSW-45303 ID Yes

Addresses

Primary practice location

250 S Main St
Payette, ID 83661-2853

Mailing address

250 S Main St
Payette, ID 83661-2853
Phone (208) 406-4245

Other providers in Payette, ID

All providers in Payette, ID · Clinical Social Worker in Idaho

Sources for this page

Verify at the official NPI Registry.