Individual provider Active NPI

Jo-Ellen Watson, PH.D. , LICSW

  • Clinical Social Worker
  • Boise, ID
National Provider Identifier
1285425520
Registry record updated Jan 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LW00008179 Issued in WA
Practice address
505 S Ash St Apt 120
Boise, ID 83702-6938
Phone
(206) 715-2733
NPI assigned
May 15, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X LCSW-40458 ID
Clinical Social Worker 1041C0700X LW00008179 WA Primary
Clinical Social Worker 1041C0700X LCSW-40458 ID

Addresses

Primary practice location

505 S Ash St Apt 120
Boise, ID 83702-6938

Mailing address

505 S Ash St Apt 120
Boise, ID 83702-6938
Phone (206) 715-2733

Other practice location 1

13477 W Bluebonnet Dr
Boise, ID 83713-1341
Phone (208) 254-1112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20251218003201 WA Practitioner - Clinical Social Worker 0244725000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
LCSW-40458IDMDMental Health Counselor
LW00008179WAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Nov 12, 2025 Accepting new patients
Clear Skies Therapy Center Multi-Specialty PastSince Jan 1, 2023 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

1455 NW Leary Way
Ste 400
Seattle, WA 98107
Phone (206) 202-8506

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769644800000",
    "number": "1285425520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 S ASH ST APT 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026938",
            "telephone_number": "206-715-2733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S ASH ST APT 120",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837026938",
            "telephone_number": "206-715-2733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13477 W Bluebonnet Dr",
            "address_purpose": "LOCATION",
            "city": "Boise",
            "state": "ID",
            "postal_code": "837131341",
            "country_code": "US",
            "telephone_number": "208-254-1112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WATSON",
        "first_name": "JO-ELLEN",
        "name_prefix": "Dr.",
        "credential": "PH.D. , LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-05-15",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "ID",
            "license": "LCSW-40458",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00008179",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "LCSW-40458",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boise, ID

Sources for this page

Verify at the official NPI Registry.