Jaci Eren Urie, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-24440 Issued in ID

Practice address

630 Addison Ave W
Twin Falls, ID 83301-5491

Phone

(208) 736-5048

NPI assigned

Jul 23, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Twin Falls County

  dba Treatment and Recovery Clinic

  • Community/Behavioral Health Agency
  • Twin Falls, ID
  • NPI 1558606962
  NPD Authorized official

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1083056709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 ADDISON AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015491",
            "telephone_number": "208-736-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 ADDISON AVE W",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015491",
            "telephone_number": "208-736-5048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URIE",
        "first_name": "JACI",
        "middle_name": "EREN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-24440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1558606962",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Uptream Living Solutions & Mobile Therapy LLC
• Jeffrey Samuel Ure, PA-C
• Urgent Care of Idaho, LLC
• Urgent Care of Idaho, LLC (Urgent Care of Idaho)
• Urgent Care of Idaho, LLC (Urgent Care of Idaho)
• John Urrutia, P.A.C
• Jason Ross Urry, OTR/L
• Murvat Usmanova, FNP
• Valley Pathology Associates PLLC
• Taylor Anne Van Holland, LCPC

• Clinical Social Worker in Twin Falls, ID
• Providers in Twin Falls, 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 23, 2020; 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.