Individual provider Active NPI

Jenna C Brehm-Gibson, LCSW

  • Clinical Social Worker
  • Twin Falls, ID
National Provider Identifier
1255871455
Registry record updated Jul 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
5358 Issued in ND
Practice address
742 Carriage LN N
Twin Falls, ID 83301-7589
Phone
(541) 778-5656
NPI assigned
Mar 7, 2017
Last updated
Jul 9, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5358 ND
Clinical Social Worker 1041C0700X 5358 ND Primary

Addresses

Primary practice location

742 Carriage LN N
Twin Falls, ID 83301-7589

Mailing address

3301 43Rd Ave S
Fargo, ND 58104-6638
Phone (541) 778-5656

Other practice location 1

316 8th St SW
Jamestown, ND 58401-4639
Phone (541) 778-5656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND
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
I20231130000839 ND Practitioner - Clinical Social Worker 3678921772 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

316 8TH St SW
Jamestown, ND 58401-4639

6046 14TH St S
Fargo, ND 58104-7340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5358NDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Serene Counseling PLLC Social Worker CurrentSince Nov 1, 2023 Accepting new patients
Soaring Free PLLC Clinical Current Accepting new patients

Locations

6046 14th St S
Fargo, ND 58104
Phone (701) 471-7092

311 1st Ave S
Ste 1
Jamestown, ND 58401

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783555200000",
    "number": "1255871455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3301 43RD AVE S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581046638",
            "telephone_number": "541-778-5656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 CARRIAGE LN N",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833017589",
            "telephone_number": "541-778-5656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "316 8th St SW",
            "address_purpose": "LOCATION",
            "city": "Jamestown",
            "state": "ND",
            "postal_code": "584014639",
            "country_code": "US",
            "telephone_number": "541-778-5656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BREHM-GIBSON",
        "first_name": "JENNA",
        "middle_name": "C",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "5358",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "5358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Twin Falls, ID

Sources for this page

Verify at the official NPI Registry.