Active NPI
Jessica Lamae Custer, LMSW
- Social Worker
- Coeur D Alene, ID
National Provider Identifier
1043701766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 37733
- Practice address
- 1200 W Ironwood Dr
Coeur D Alene, ID 83814-2660 - Phone
- (208) 664-9729
- NPI assigned
- May 29, 2018
- Sex
- Female
- 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 | 37733 | ID | Primary |
Addresses
Primary practice location
1200 W Ironwood Dr
Coeur D Alene, ID 83814-2660
Mailing address
1007 N 11TH St
Coeur D Alene, ID 83814-4420
Phone (509) 969-9254
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 |
|---|---|---|---|
| 37733 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527552000000",
"number": "1043701766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1007 N 11TH ST",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838144420",
"telephone_number": "509-969-9254"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 W IRONWOOD DR",
"city": "COEUR D ALENE",
"state": "ID",
"postal_code": "838142660",
"telephone_number": "208-664-9729"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CUSTER",
"first_name": "JESSICA",
"middle_name": "LAMAE",
"name_prefix": "Mrs.",
"credential": "LMSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-29",
"last_updated": "2018-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "37733",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coeur D Alene, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.