Individual provider Active NPI

Brianne Heimbuch, LCSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1285377309
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW-43446 Issued in ID
Practice address
6154 N Royal Park Ave
Boise, ID 83713-1294
Phone
(208) 391-3773
NPI assigned
Apr 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 LMSW-37710 ID
Clinical Social Worker 1041C0700X LCSW-43446 ID Primary

Addresses

Primary practice location

6154 N Royal Park Ave
Boise, ID 83713-1294

Mailing address

6154 N Royal Park Ave
Boise, ID 83713-1294

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 12, 2024 through Feb 12, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LMSW-37710IDMDSocial Worker
LCSW-43446IDMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1650067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1285377309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6154 N ROYAL PARK AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131294"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6154 N ROYAL PARK AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837131294",
            "telephone_number": "208-391-3773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIMBUCH",
        "first_name": "BRIANNE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-16",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ID",
            "license": "LMSW-37710",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-43446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.