Shasta Lee Hardee, LMSW-37764

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-37764 Issued in ID

Practice address

2235 E 25TH St
Idaho Falls, ID 83404

Phone

(208) 643-2832

Fax

(085) 382-2332

NPI assigned

May 14, 2008

Last updated

Jun 7, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Clinical Social Worker

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Willow Sage Services LLCGroup PAC ID 8527341007, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Willow Sage Services LLC

  • Counselor
  • Idaho Falls, ID
  • NPI 1538611652

  Social Worker

  Medicare reassignment Care Compare group NPD
• Alliance Home Health of Idaho, LLC

  dba Alliance Hospice

  • Community Based Hospice Care Agency
  • Twin Falls, ID
  • NPI 1467772897
  NPD (past)

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

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1194992545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 BOWER DR",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834045151",
            "telephone_number": "208-680-6135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2235 E 25TH ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "83404",
            "telephone_number": "208-643-2832",
            "fax_number": "085-382-2332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDEE",
        "first_name": "SHASTA",
        "middle_name": "LEE",
        "credential": "LMSW-37764",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-14",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-37764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002648300",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807375600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lyndsay Jane Hanson
• Marc Hanson, MOTR/L
• Pamela Jo Hanson, CASE MANAGER
• Ray William Hanson, MD
• Rex Hanson, LSW
• Elizabeth Roberta Harding, LCSW, CSW
• Camille Hardman, LPC, NCC
• Lisa Ann Hardy, R.D. L.D.
• Quincy Kaye Hardy, FNP-C
• Gracie Ann Hargraves, ED.D, LCPC

• Social Worker in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.