Active NPI
Karen Gentilman, LCSW
- Clinical Social Worker
- Boise, ID
National Provider Identifier
1063961951
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-36120
- Practice address
- 600 N Robbins Rd
Boise, ID 83702-4565 - Phone
- (208) 385-3244
- Fax
- (208) 489-4052
- NPI assigned
- Oct 3, 2016
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-36120 | ID | Primary |
Addresses
Primary practice location
600 N Robbins Rd
Boise, ID 83702-4565
Mailing address
600 N Robbins Rd
Boise, ID 83702-4565
Phone (208) 385-3244
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 10, 2024 through Feb 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1475452800000",
"number": "1063961951",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 N ROBBINS RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837024565",
"telephone_number": "208-385-3244",
"fax_number": "208-489-4052"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N ROBBINS RD",
"city": "BOISE",
"state": "ID",
"postal_code": "837024565",
"telephone_number": "208-385-3244",
"fax_number": "208-489-4052"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENTILMAN",
"first_name": "KAREN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-10-03",
"last_updated": "2016-10-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-36120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.