Individual provider Active NPI

Serria Kathleen Sarrazolla, LCSW

  • Social Worker
  • Meridian, ID
National Provider Identifier
1104559293
Registry record updated Mar 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
LCSW-43872 Issued in ID
Practice address
3313 W Cherry LN Ste 103
Meridian, ID 83642-1119
Phone
(360) 610-5051
NPI assigned
Jul 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-43872 ID
Social Worker 104100000X LCSW-43872 ID Primary

Addresses

Primary practice location

3313 W Cherry LN Ste 103
Meridian, ID 83642-1119

Mailing address

3313 W Cherry LN Ste 103
Meridian, ID 83642-1119
Phone (360) 610-5051

Other names 1

  • Mrs. Sierra Kathleen Sarrazolla Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240920001610 ID Practitioner - Clinical Social Worker 2668913302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lifepath Services LLCGroup PAC ID 9638487515, 8 clinicians

Practice addresses (Care Compare)

8675 W Ardene St
Boise, ID 83709-2601
Phone (208) 780-3902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-43872IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifepath Services LLC CurrentSince Sep 1, 2024 Accepting new patients

Locations

8675 W Ardene St
Boise, ID 83709
Phone (208) 780-3900

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773705600000",
    "number": "1104559293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3313 W CHERRY LN STE 103",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421119",
            "telephone_number": "360-610-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 W CHERRY LN STE 103",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836421119",
            "telephone_number": "360-610-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARRAZOLLA",
        "first_name": "SERRIA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-06",
        "last_updated": "2026-03-17",
        "certification_date": "2026-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-43872",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LCSW-43872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SIERRA",
            "last_name": "SARRAZOLLA",
            "middle_name": "KATHLEEN",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Meridian, ID

Sources for this page

Verify at the official NPI Registry.