Individual provider Active NPI

Ciarra N Fuller, LCSW

  • Clinical Social Worker
  • Nampa, ID
National Provider Identifier
1265101927
Registry record updated Oct 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-44557 Issued in ID
Practice address
1425 W Sheridan Ave
Nampa, ID 83686-9713
Phone
(208) 740-9234
NPI assigned
Sep 7, 2021
Last updated
Oct 9, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 9, 2025

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 LCSW-44557 ID Primary

Addresses

Primary practice location

1425 W Sheridan Ave
Nampa, ID 83686-9713

Mailing address

1425 W Sheridan Ave
Nampa, ID 83686-9713
Phone (208) 740-9234

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
Eligible to order & refer
  • Part B services: No
  • 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
I20240205001333 ID Practitioner - Clinical Social Worker 0446693725 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Access Behavioral Health Services CurrentSince Jan 22, 2024 Accepting new patients
Access Behavioral Health Services, Inc CurrentSince Jan 22, 2024 Accepting new patients
Mental Health Specialists Clinical PastSince Sep 1, 2021 Accepting new patients
Demren Lahhf, LLC Past Accepting new patients

Locations

1276 W River St
Ste 100
Boise, ID 83702
Phone (208) 338-4699

3307 Caldwell Blvd
Ste 104
Nampa, ID 83651
Phone (208) 465-4833

Organizations & group practices 4

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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759968000000",
    "number": "1265101927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 W SHERIDAN AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836869713",
            "telephone_number": "208-740-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 W SHERIDAN AVE",
            "city": "NAMPA",
            "state": "ID",
            "postal_code": "836869713",
            "telephone_number": "208-740-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CIARRA",
        "middle_name": "N",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-07",
        "last_updated": "2025-10-09",
        "certification_date": "2025-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-44557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nampa, ID

Sources for this page

Verify at the official NPI Registry.