Gericare of Idaho, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-29777 Issued in ID

Legal business name

GERICARE OF IDAHO, LLC

Practice address

5442 S Farmhouse PL
Boise, ID 83716-9016

Phone

(208) 830-6775

NPI assigned

Apr 9, 2010

Organization subpart

No

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

Authorized official

Name

Bernard M Berlin, LCSW

Title

Owner

Phone

(208) 830-6775

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1270771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270771200000",
    "number": "1144546649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 WARD ROAD",
            "address_2": "SUITE 106",
            "city": "ARVADA",
            "state": "CO",
            "postal_code": "800021829",
            "telephone_number": "303-278-7418",
            "fax_number": "888-341-5050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5442 S FARMHOUSE PL",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837169016",
            "telephone_number": "208-830-6775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERICARE OF IDAHO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-09",
        "last_updated": "2010-04-09",
        "status": "A",
        "authorized_official_last_name": "BERLIN",
        "authorized_official_first_name": "BERNARD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-830-6775",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-29777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "LCS 10041",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "LCSW-29777",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Geraty
• Jacob Carlton Gere, PNP
• Jenna Lindsay Gere, PNP
• Julia Penelope Gerhardt, LCSW
• Monica M Gerhart, PT
• Suzanne Rebecca Gerlach, BS PSYCH
• Ninon Marie Germain Collet, M.D.
• Frank Alan Germano, M.D.
• Gregory Germano
• Katherine Dawn Gerosin-Shaffer, CPM, LM

• Clinical Social Worker in Boise, ID
• Providers in Boise, 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 Apr 9, 2010; 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.