Audrey Oliver, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

2121 N Garnet Creek Ave
Star, ID 83669-8001

Phone

(208) 740-0544

NPI assigned

Feb 14, 2018

Sole proprietor

Yes

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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ami Owen PLLC

  • Mental Health Counselor
  • Star, ID
  • NPI 1275262727
  NPD

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

{
    "created_epoch": "1518566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1073013207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 N GARNET CREEK AVE",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836698001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 N GARNET CREEK AVE",
            "city": "STAR",
            "state": "ID",
            "postal_code": "836698001",
            "telephone_number": "208-740-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVER",
        "first_name": "AUDREY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "U",
        "enumeration_date": "2018-02-14",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian David Nichols, MPT ATC
• Judianne King Nichols, MPT
• Nitai Truenorth Counseling LLC
• Nitai Truenorthcounseling LLC
• Nutrithrive LLC
• Mark Olsen, D.D.S.
• Carrie Otterness
• Ami Laura Owen, LMFT
• Owyhee Family Medicine PLLC
• Marian Therese Peloquin, MS, CCC-SLP

• All providers in Star, ID
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2024; 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.