Shalyce Anderson
Individual provider Active NPI Social Worker · Twin Falls, ID
NPI 1003509720 · NPPES record last updated May 30, 2023
Key facts
- NPI
- 1003509720
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- LMSW-42603 (ID)
- Practice address
- 801 Pole Line Rd W
Twin Falls, ID 83301-5810 - Phone
- (208) 670-5214
- NPI assigned
- May 30, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-42603 | ID | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-42603 | ID | Yes |
Addresses
Primary practice location
801 Pole Line Rd W
Twin Falls, ID 83301-5810
Mailing address
801 Pole Line Rd W
Twin Falls, ID 83301-5810
Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 30, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.