Active NPI
Braden Clark McDonald, LMSW
- Social Worker
- Twin Falls, ID
National Provider Identifier
1043620115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 8729371-3502
- Practice address
- 361 2ND Ave West
Twin Falls, ID 83301 - Phone
- (208) 308-7533
- NPI assigned
- Apr 29, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 8729371-3502 | ID | Primary |
Addresses
Primary practice location
361 2ND Ave West
Twin Falls, ID 83301
Mailing address
361 2ND Ave W
361 2ND Ave West
Twin Falls, ID 83301-5804
Phone (208) 308-7533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8729371-3502 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1398729600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398729600000",
"number": "1043620115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "361 2ND AVE W",
"address_2": "361 2ND AVE WEST",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "833015804",
"telephone_number": "208-308-7533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "361 2ND AVE WEST",
"city": "TWIN FALLS",
"state": "ID",
"postal_code": "83301",
"telephone_number": "208-308-7533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "BRADEN",
"middle_name": "CLARK",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-29",
"last_updated": "2014-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "8729371-3502",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Twin Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.