Individual provider Active NPI

Jamie Leann Perry, LCSW

  • Clinical Social Worker
  • Caldwell, ID
National Provider Identifier
1144699307
Registry record updated Apr 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8851764 Issued in ID
Practice address
4605 Enterprise Way Ste 105
Caldwell, ID 83605-6889
Phone
(208) 614-4122
NPI assigned
Sep 17, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X LMSW 35174 ID
Clinical Social Worker 1041C0700X 8851764 ID Primary

Addresses

Primary practice location

4605 Enterprise Way Ste 105
Caldwell, ID 83605-6889

Mailing address

1509 Fairview Ave
Caldwell, ID 83605-4609
Phone (208) 936-8843

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
I20250117003033 ID Practitioner - Clinical Social Worker 7315476447 Practice locations: Caldwell, ID

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4605 Enterprise Way
Suite 105
Caldwell, ID 83605-6889
Phone (208) 614-4122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMSW 35174IDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Ministries Syringa Wellness CurrentSince Nov 20, 2024 Accepting new patients

Locations

1609 S Kimball Ave
#202
Caldwell, ID 83605
Phone (208) 899-8101

1609 S Kimball Ave
Ste 200
Caldwell, ID 83605
Phone (208) 899-8101

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": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745971200000",
    "number": "1144699307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 FAIRVIEW AVE",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836054609",
            "telephone_number": "208-936-8843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4605 ENTERPRISE WAY STE 105",
            "city": "CALDWELL",
            "state": "ID",
            "postal_code": "836056889",
            "telephone_number": "208-614-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERRY",
        "first_name": "JAMIE",
        "middle_name": "LEANN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-17",
        "last_updated": "2025-04-30",
        "certification_date": "2025-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW 35174",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "8851764",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caldwell, ID

Sources for this page

Verify at the official NPI Registry.