Individual provider Active NPI

Federica Lanza, LCSW

  • Clinical Social Worker
  • Eagle, ID
National Provider Identifier
1174711659
Registry record updated Mar 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-33657 Issued in ID
Practice address
1243 E Iron Eagle Dr Ste 130D
Eagle, ID 83616-6599
Phone
(208) 684-2585
Fax
(208) 547-6835
NPI assigned
Oct 9, 2007
Last updated
Mar 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-33657 ID Primary

Addresses

Primary practice location

1243 E Iron Eagle Dr Ste 130D
Eagle, ID 83616-6599

Mailing address

1243 E Iron Eagle Dr Ste 130D
Eagle, ID 83616-6599
Phone (208) 684-2585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jan 27, 2024 through Jan 27, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LCSW-33657IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Yes Counseling, PLLC CurrentSince Jun 15, 2025 Accepting new patients
Las Cruces School District No. 2 PastSince Nov 8, 2020 Accepting new patients

Locations

1243 E Iron Eagle Dr
Ste 130D
Eagle, ID 83616
Phone (208) 391-7050

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583020800000",
    "number": "1174711659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1243 E IRON EAGLE DR STE 130D",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166599",
            "telephone_number": "208-684-2585",
            "fax_number": "208-547-6835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1243 E IRON EAGLE DR STE 130D",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166599",
            "telephone_number": "208-684-2585",
            "fax_number": "208-547-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANZA",
        "first_name": "FEDERICA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-09",
        "last_updated": "2020-03-01",
        "certification_date": "2020-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-33657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.