Individual provider Active NPI

Alan Glen Neighbors, LCSW

  • Clinical Social Worker
  • Eagle, ID
National Provider Identifier
1265874184
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
36531 Issued in ID
Practice address
1025 S Bridgeway PL Ste 280
Eagle, ID 83616-6834
Phone
(208) 412-7740
Fax
(208) 853-1318
NPI assigned
Jul 19, 2013
Last updated
Sep 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 33151 IA
Clinical Social Worker 1041C0700X 36531 ID Primary

Addresses

Primary practice location

1025 S Bridgeway PL Ste 280
Eagle, ID 83616-6834

Mailing address

1025 S Bridgeway PL Ste 280
Eagle, ID 83616-6834
Phone (208) 412-7762

Other practice location 1

815 S Bridge Way Pl
Suite 118
Eagle, ID 83616-6006
Phone (208) 412-7740

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
I20180216000262 ID Practitioner - Clinical Social Worker 9032357223 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
A New Beginning Counseling Center PCGroup PAC ID 3375600604, 3 clinicians

Practice addresses (Care Compare)

1025 S Bridgeway PL
Suite 280
Eagle, ID 83616-6834
Phone (208) 412-7740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
33151IAMDClinical Social Worker
36531IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
A New Beginning Counseling Center, PC. CurrentSince Jun 20, 2020 Accepting new patients
A New Beginning Health and Healing Center Clinical PastSince Jun 20, 2020 Accepting new patients

Locations

1025 S Bridgeway Pl
Ste 280
Eagle, ID 83616
Phone (208) 412-7740

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": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1265874184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1025 S BRIDGEWAY PL STE 280",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166834",
            "telephone_number": "208-412-7762",
            "fax_number": "208-853-1318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 S BRIDGEWAY PL STE 280",
            "city": "EAGLE",
            "state": "ID",
            "postal_code": "836166834",
            "telephone_number": "208-412-7740",
            "fax_number": "208-853-1318"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "815 S Bridge Way Pl",
            "address_2": "Suite 118",
            "address_purpose": "LOCATION",
            "city": "Eagle",
            "state": "ID",
            "postal_code": "836166006",
            "country_code": "US",
            "telephone_number": "208-412-7740",
            "fax_number": "208-853-1318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEIGHBORS",
        "first_name": "ALAN",
        "middle_name": "GLEN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-19",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "33151",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "36531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle, ID

Sources for this page

Verify at the official NPI Registry.