Individual provider Active NPI

Jyl E Adams, LCSW

  • Clinical Social Worker
  • Eagle, ID
National Provider Identifier
1184764474
Registry record updated Dec 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW 28551 Issued in ID
Practice address
596 W Oakhampton Dr
Eagle, ID 83616-6741
Phone
(208) 321-4166
Fax
(208) 321-4167
NPI assigned
Feb 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW 28551 ID Primary
Clinical Social Worker 1041C0700X 11376-C NV

Addresses

Primary practice location

596 W Oakhampton Dr
Eagle, ID 83616-6741

Mailing address

596 W Oakhampton Dr
Eagle, ID 83616-6741
Phone (208) 484-3359

Other names 1

  • Mrs. Jyl E Adams Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID, NV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090812000952 ID Practitioner - Clinical Social Worker 3173676400 Reassigns benefits to 1 organization
I20250708003517 NV Practitioner - Clinical Social Worker 3173676400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

203 S Water St
Suite 206
Henderson, NV 89015-7226
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW 28551IDMDClinical Social Worker
11376-CNVMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Feb 28, 2025 Accepting new patients

Locations

950 W Bannock St
Boise, ID 83702
Phone (208) 602-7007

203 S Water St
Ste 206
Henderson, NV 89015

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734048000000",
    "number": "1184764474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 W OAKHAMPTON DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166741",
            "telephone_number": "208-484-3359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 W OAKHAMPTON DR",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166741",
            "telephone_number": "208-321-4166",
            "fax_number": "208-321-4167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "JYL",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-07",
        "last_updated": "2024-12-13",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW 28551",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "11376-C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JYL",
            "last_name": "ADAMS",
            "middle_name": "E",
            "prefix": "MRS.",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.