Individual provider Active NPI

Shira Urias, LCSW

  • Clinical Social Worker
  • Coeur D Alene, ID
National Provider Identifier
1225675663
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW39048 Issued in ID
Practice address
2201 N Ironwood PL Ste 100
Coeur D Alene, ID 83814-2670
Phone
(208) 769-4222
Fax
(844) 803-7399
NPI assigned
Dec 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW39048 ID Primary

Addresses

Primary practice location

2201 N Ironwood PL Ste 100
Coeur D Alene, ID 83814-2670

Mailing address

PO Box 1387
Hayden, ID 83835-1387
Phone (208) 415-0299

Other identifiers 1

IdentifierTypeStateIssuer
CD266847BOtherIDDRIVERS LICENSE

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20200130002270 ID Practitioner - Clinical Social Worker 5395171953 Practice locations: Coeur D Alene, ID

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1042 W Mill Ave
Suite 104
Coeur D Alene, ID 83814-2489
Phone (208) 771-7308

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW39048IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Freedom Counseling, PLLC CurrentSince Oct 27, 2021 Accepting new patients
Dirne Health Centers, Inc. Clinical PastSince Dec 9, 2019 Accepting new patients

Locations

1042 W Mill Ave
Ste 104
Coeur D Alene, ID 83814
Phone (208) 659-6526

Organizations & group practices 2

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": "1575417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1225675663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387",
            "telephone_number": "208-415-0299",
            "fax_number": "208-625-2070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 N IRONWOOD PL STE 100",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142670",
            "telephone_number": "208-769-4222",
            "fax_number": "844-803-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URIAS",
        "first_name": "SHIRA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-04",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW39048",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "CD266847B",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coeur D Alene, ID

Sources for this page

Verify at the official NPI Registry.