Active NPI
Sylinda Lee Mendenhall, LCSW
- Clinical Social Worker
- Idaho Falls, ID
National Provider Identifier
1164040820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 39541
- Practice address
- 771 S Jafer Court
Idaho Falls, ID 83401-8404 - Phone
- (435) 760-0685
- NPI assigned
- Jul 9, 2020
- 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 | 39541 | ID | Primary |
Addresses
Primary practice location
771 S Jafer Court
Idaho Falls, ID 83401-8404
Mailing address
771 S Jafer Court
Idaho Falls, ID 83401
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 |
|---|---|---|---|
| 39541 | ID | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1594252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1594252800000",
"number": "1164040820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "771 S JAFER COURT",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "83401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "771 S JAFER COURT",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834018404",
"telephone_number": "435-760-0685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENDENHALL",
"first_name": "SYLINDA",
"middle_name": "LEE",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-09",
"last_updated": "2020-07-09",
"certification_date": "2020-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "39541",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.