Active NPI
Kathleen S Tomazin, LCPC
- Social Worker
- Blackfoot, ID
National Provider Identifier
1194942185
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LSW 1810
- Practice address
- 90 W Judicial St
Blackfoot, ID 83221-2715 - Phone
- (208) 782-2060
- Fax
- (208) 782-0209
- NPI assigned
- Apr 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LCPC 332 | ID | |
| Social Worker | 104100000X | LSW 1810 | ID | Primary |
Addresses
Primary practice location
90 W Judicial St
Blackfoot, ID 83221-2715
Mailing address
90 W Judicial St
Blackfoot, ID 83221-2715
Phone (208) 782-2060
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 80662262 | Medicaid | ID | |
| 8059327 | Medicaid | ID |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCPC 332 | ID | MD | Professional Counselor |
| LSW 1810 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1194942185",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "90 W JUDICIAL ST",
"city": "BLACKFOOT",
"state": "ID",
"postal_code": "832212715",
"telephone_number": "208-782-2060",
"fax_number": "208-782-0209"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "90 W JUDICIAL ST",
"city": "BLACKFOOT",
"state": "ID",
"postal_code": "832212715",
"telephone_number": "208-782-2060",
"fax_number": "208-782-0209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOMAZIN",
"first_name": "KATHLEEN",
"middle_name": "S",
"name_prefix": "Mrs.",
"credential": "LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LCPC 332",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LSW 1810",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "80662262",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8059327",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blackfoot, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.