Individual provider Active NPI

Devoney Kodad, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1265941686
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
103628 Issued in CA
Practice address
582 E Boise Ave Unit 2017
Boise, ID 83706-5116
Phone
(208) 254-0546
NPI assigned
Sep 28, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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 6061179 ID
Clinical Social Worker 1041C0700X 103628 CA Primary

Addresses

Primary practice location

582 E Boise Ave Unit 2017
Boise, ID 83706-5116

Mailing address

582 E Boise Ave Unit 2017
Boise, ID 83706-5116
Phone (208) 254-0546

Other practice location 1

3609 Sacramento St
San Francisco, CA 94118-1709
Phone (619) 804-7200

Other practice location 2

784 S Clearwater Loop Ste R
Post Falls, ID 83854-9599
Phone (208) 254-0546

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
103628CAMDClinical Social Worker
6061179IDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Free & Well Clinical CurrentSince Jan 26, 2025 Accepting new patients

Locations

784 W Clear Water Loop
Post Falls, ID 83854
Phone (206) 317-1200

Organizations & group practices 1

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": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1265941686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 E BOISE AVE UNIT 2017",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065116",
            "telephone_number": "208-254-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "582 E BOISE AVE UNIT 2017",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065116",
            "telephone_number": "208-254-0546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3609 Sacramento St",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941181709",
            "country_code": "US",
            "telephone_number": "619-804-7200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "784 S Clearwater Loop Ste R",
            "address_purpose": "LOCATION",
            "city": "Post Falls",
            "state": "ID",
            "postal_code": "838549599",
            "country_code": "US",
            "telephone_number": "208-254-0546",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KODAD",
        "first_name": "DEVONEY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-28",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "6061179",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "103628",
            "primary": true
        }
    ],
    "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 Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.