Kelli Spaulding, LMSW
Individual provider Active NPI Social Worker · Pocatello, ID
NPI 1073347597 · NPPES record last updated Aug 27, 2024
Key facts
- NPI
- 1073347597
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 8361074 (ID)
- Practice address
- 151 N 3Rd Ave Ste 330
Pocatello, ID 83201-6369 - Phone
- (208) 242-3771
- NPI assigned
- Aug 27, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8361074 | ID | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gateway Counseling Incorporated | Current |
Accepting new patients |
Locations
151 N 3rd Ave
Ste 330
Pocatello, ID 83201
Phone (208) 242-3771
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 8361074 | ID | Yes |
Addresses
Primary practice location
151 N 3Rd Ave Ste 330
Pocatello, ID 83201-6369
Mailing address
1248 Cobie LN
Ammon, ID 83406-4629
Phone (208) 440-3129
Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 27, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.