Glenn James Larock, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LCSW-35629 Issued in ID

Practice address

100 E Idaho St
Boise, ID 83712-6267

Phone

(208) 381-2711

Fax

(208) 381-4025

NPI assigned

Sep 27, 2006

Last updated

Oct 4, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696377600000",
    "number": "1194816884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "190 E BANNOCK ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E IDAHO ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837126267",
            "telephone_number": "208-381-2711",
            "fax_number": "208-381-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAROCK",
        "first_name": "GLENN",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "110763",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089 0092617",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-35629",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "P08083",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP PROVIDER NUMBER",
            "identifier": "1063650",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN PROVIDER NUMBER",
            "identifier": "416714",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian James Larkin, D.O.
• William A Larkin, DDS
• Angela Rae Larkins, APRN
• Amber Larocco, CADC
• Michael L Larocco, LCSW
• Augustine Larsen Ruff, LMSW
• Christine Larsen, RN, BSN
• Elizabeth Larsen, RN
• Olivia Anne Larsen, ATC
• Sophia Claire Larsen

• Clinical Social Worker in Boise, ID
• Providers in Boise, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.