Brandy L Allen
Individual provider Active NPI Social Worker · Lewiston, ID
NPI 1144045758 · NPPES record last updated Nov 22, 2024
Key facts
- NPI
- 1144045758
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 8921930 (ID)
- Practice address
- 1706 G St
Lewiston, ID 83501-2021 - Phone
- (208) 751-0478
- NPI assigned
- Nov 19, 2024
- 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)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8921930 | ID | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 8921930 | ID | Yes |
Addresses
Primary practice location
1706 G St
Lewiston, ID 83501-2021
Mailing address
46987 Highway 95
Lapwai, ID 83540-5146
Phone (208) 252-2692
Other providers in Lewiston, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 22, 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.