Active NPI
Casey Margaret Sullivan, LMSW
- Clinical Social Worker
- Boise, ID
National Provider Identifier
1235754128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-44226
- Practice address
- 6533 W Emerald St
Boise, ID 83704-8737 - Phone
- (208) 367-2126
- Fax
- (208) 367-7410
- NPI assigned
- Jun 16, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-44226 | ID | Primary |
| Social Worker | 104100000X | LMSW-39715 | ID |
Addresses
Primary practice location
6533 W Emerald St
Boise, ID 83704-8737
Mailing address
PO Box 190930
Boise, ID 83719-0930
Phone (208) 367-2126
Other practice location 1
7941 W Rifleman St
Boise, ID 83704-9001
Phone (208) 895-7950
Other practice location 2
847 Parkcentre Way Ste 7
Nampa, ID 83651-1794
Phone (208) 229-6050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-39715 | ID | MD | Social Worker |
| LCSW-44226 | ID | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Saint Alphonsus Regional Medical Center Inc | Current | Accepting new patients | |
| Saint Alphonsus Regional Medical Center Inc | Clinical | Current | Accepting new patients |
| Saint Alphonsus Regional Medical Center Inc | Current | Accepting new patients | |
| Ashwood Recovery LLC | Past | Accepting new patients | |
| Ashwood Recovery LLC | Past | Accepting new patients |
Locations
6533 W Emerald St
Boise, ID 83704
Phone (208) 302-5200
3025 W Cherry Ln
Ste B
Meridian, ID 83642
Phone (208) 302-6400
Organizations & group practices 5
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.
-
- Psychiatric Hospital Unit
- Boise, ID
- NPI 1770687857
-
- Family Medicine Physician
- Caldwell, ID
- NPI 1861676298
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Boise, ID
- NPI 1043545106
-
- Substance Use Disorder Rehabilitation Clinic/Center
- Boise, ID
- NPI 1801452677
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1235754128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 190930",
"city": "BOISE",
"state": "ID",
"postal_code": "837190930",
"telephone_number": "208-367-2126",
"fax_number": "208-367-7410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6533 W EMERALD ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837048737",
"telephone_number": "208-367-2126",
"fax_number": "208-367-7410"
}
],
"practiceLocations": [
{
"address_1": "7941 W Rifleman St",
"address_purpose": "LOCATION",
"city": "Boise",
"state": "ID",
"postal_code": "837049001",
"country_code": "US",
"telephone_number": "208-895-7950",
"fax_number": "855-212-5682",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "847 Parkcentre Way Ste 7",
"address_purpose": "LOCATION",
"city": "Nampa",
"state": "ID",
"postal_code": "836511794",
"country_code": "US",
"telephone_number": "208-229-6050",
"fax_number": "855-212-5682",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SULLIVAN",
"first_name": "CASEY",
"middle_name": "MARGARET",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-16",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-44226",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW-39715",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; 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.