Active NPI
Terry H Hernandez-Ruelas, LCSW
- Clinical Social Worker
- Nampa, ID
National Provider Identifier
1194012591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-36255
- Practice address
- 215 E Hawaii Ave
Nampa, ID 83686 - Phone
- (208) 463-3000
- Fax
- (208) 463-3034
- NPI assigned
- Jul 6, 2011
- 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 | LCSW-36255 | ID | Primary |
Addresses
Primary practice location
215 E Hawaii Ave
Nampa, ID 83686
Mailing address
2505 Marshall PL
Caldwell, ID 83605-1682
Phone (208) 463-3000
Other practice location 1
108 E Idaho
Homedale, ID 83628
Phone (208) 461-7149 ext. 3207
Other practice location 2
9850 St Lukes Dr Ste 129
Nampa, ID 83687-7912
Phone (208) 463-3000
Other practice location 3
3277 E Louise Dr Ste 200
Meridian, ID 83642-9360
Phone (208) 463-3000
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 |
|---|---|---|---|
| LCSW-36255 | ID | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Interpath Laboratory, Inc. | Past | Accepting new patients |
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.
-
- Clinical Medical Laboratory
- Pendleton, OR
- NPI 1548208440
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309910400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615334400000",
"number": "1194012591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2505 MARSHALL PL",
"city": "CALDWELL",
"state": "ID",
"postal_code": "836051682",
"telephone_number": "208-463-3000",
"fax_number": "208-463-3034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 E HAWAII AVE",
"city": "NAMPA",
"state": "ID",
"postal_code": "83686",
"telephone_number": "208-463-3000",
"fax_number": "208-463-3034"
}
],
"practiceLocations": [
{
"address_1": "108 E Idaho",
"address_purpose": "LOCATION",
"city": "Homedale",
"state": "ID",
"postal_code": "83628",
"country_code": "US",
"telephone_number": "208-461-7149 x3207",
"fax_number": "208-467-3391",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "9850 St Lukes Dr Ste 129",
"address_purpose": "LOCATION",
"city": "Nampa",
"state": "ID",
"postal_code": "836877912",
"country_code": "US",
"telephone_number": "208-463-3000",
"fax_number": "208-463-3034",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3277 E Louise Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Meridian",
"state": "ID",
"postal_code": "836429360",
"country_code": "US",
"telephone_number": "208-463-3000",
"fax_number": "208-463-3034",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HERNANDEZ-RUELAS",
"first_name": "TERRY",
"middle_name": "H",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-06",
"last_updated": "2021-03-10",
"certification_date": "2021-03-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-36255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.