Jacqueline A Shafer, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW40964 Issued in ID

Practice address

90 Hope Dr
Mountain Home Afb, ID 83648-1057

Phone

(208) 828-7531

NPI assigned

Jan 31, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1053819300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 HOPE DR BLDG 6000",
            "city": "MOUNTAIN HOME AFB",
            "state": "ID",
            "postal_code": "836481062",
            "telephone_number": "208-828-7220",
            "fax_number": "208-828-1602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 HOPE DR",
            "city": "MOUNTAIN HOME AFB",
            "state": "ID",
            "postal_code": "836481057",
            "telephone_number": "208-828-7531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFER",
        "first_name": "JACQUELINE",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW40964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Redding, COTA
• Dennis Jacob Reuter, IDMT
• Lydia Rodriguez, WHNP
• Paul Sahwell, PH.D.
• Eva Elaine Schauer, NP-C
• Erin Siebert, PHD
• Geremy Skeen, PHARMD
• Joseph Carroll Skinner Jr., CRNA
• Keith A Smith, LMFT
• Thomas Michael Smith, LCSW

• Clinical Social Worker in Mountain Home Afb, ID
• Providers in Mountain Home Afb, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.