Tom C Ahlrichs, LCSW
Individual provider Active NPI Clinical Social Worker · Boise, ID
NPI 1013135078 · NPPES record last updated May 27, 2008
Key facts
- NPI
- 1013135078
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW-24633 (ID)
- Practice address
- 777 N Raymond St
Boise, ID 83704-9251 - Phone
- (208) 367-6044
- Fax
- (208) 375-8817
- NPI assigned
- Apr 23, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070730000066 | ID | Practitioner - Clinical Social Worker | 1759482102 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-24633 | ID | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Regional Medical Center | Past | Accepting new patients | |
| Maitri House Yoga, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-24633 | ID | Yes |
Addresses
Primary practice location
777 N Raymond St
Boise, ID 83704-9251
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 367-6044
Other providers in Boise, ID
- Caitlin Ahern
- Helen Ahern
- Shane Ahlers
- Alexandria Ahlm
- J Thomas Ahlquist
- Danielle Rae Ahlstrom
- Derek Scott Ahlstrom
- Parwiz Ahmad
- Farkhunda Ahmadi
- Melanie R Ahrens
All providers in Boise, ID · Clinical Social Worker in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.