Active NPI
Gayle Eaton, LCSW
- Clinical Social Worker
- Cascade, ID
National Provider Identifier
1124170337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW853
- Practice address
- 402 Old State Hwy
Cascade, ID 83611 - Phone
- (208) 382-4242
- Fax
- (208) 382-5081
- NPI assigned
- Jan 17, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW853 | ID | Primary |
Addresses
Primary practice location
402 Old State Hwy
Cascade, ID 83611
Mailing address
PO Box 1330
Cascade, ID 83611-1330
Phone (208) 382-4242
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| L8539 | Other | ID | BLUE CROSS OF ID |
| 000010016900 | Other | ID | REGENCE BLUE SHIELD OF ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW853 | ID | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Orthopedic Centers of Idaho P a | Past | Accepting new patients | |
| Cascade Medical Center Hospital District | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Rural Acute Care Hospital
- Cascade, ID
- NPI 1689720435
-
- Orthopaedic Surgery Physician
- Boise, ID
- NPI 1487746541
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168992000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235520000000",
"number": "1124170337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1330",
"city": "CASCADE",
"state": "ID",
"postal_code": "836111330",
"telephone_number": "208-382-4242",
"fax_number": "208-382-5081"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 OLD STATE HWY",
"city": "CASCADE",
"state": "ID",
"postal_code": "83611",
"telephone_number": "208-382-4242",
"fax_number": "208-382-5081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EATON",
"first_name": "GAYLE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-17",
"last_updated": "2009-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW853",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF ID",
"identifier": "L8539",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE BLUE SHIELD OF ID",
"identifier": "000010016900",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cascade, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.