Gina Bosco, LCSW
Individual provider Active NPI Clinical Social Worker · Burley, ID
NPI 1104802230 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1104802230
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LCSW1034 (ID)
- Practice address
- 2300 Overland Ave
Burley, ID 83318-2932 - Phone
- (208) 732-8565
- Fax
- (208) 732-8566
- NPI assigned
- Dec 20, 2005
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW1034 | ID | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW1034 | ID | Yes |
Addresses
Primary practice location
2300 Overland Ave
Burley, ID 83318-2932
Mailing address
PO Box 462
Burley, ID 83318-0462
Phone (208) 670-3900
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00001001764 | Other | ID | BLUESHIELD OF ID |
| L5550 | Other | ID | BLUECROSS OF ID |
Other providers in Burley, ID
- Travis T Bodily
- Bernard R Boehmer
- Steven Boehmer
- Meg Estelle Bollinger
- Steven L Borden
- Mathew G Bowden
- Amanda Bowen
- Rand N. Bracken
- Jesse G Bradshaw
- Daniel Joseph Brauner
All providers in Burley, ID · Clinical Social Worker in Idaho
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. 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.