Active NPI
Corrine Tafoya Fisher, ACSW LCSW
- Clinical Social Worker
- Nampa, ID
National Provider Identifier
1285759118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW562
- Practice address
- 16 12TH Ave So
Suite 103
Nampa, ID 83651 - Phone
- (208) 461-3720
- Fax
- (208) 461-1787
- NPI assigned
- Mar 20, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW562 | ID | Primary |
Addresses
Primary practice location
16 12TH Ave So
Suite 103
Nampa, ID 83651
Mailing address
16 12TH Ave So
Suite 103
Nampa, ID 83651
Phone (208) 461-3720
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 807292400 | Medicaid | ID | |
| 8M061 | Other | BLUE SHIELD | |
| E5428 | Other | ID | BLUE CROSS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW562 | ID | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook & Tafoya-Fisher Behavioral Health | Past | Accepting new patients |
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.
-
- Community/Behavioral Health Agency
- Nampa, ID
- NPI 1700084290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1285759118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 12TH AVE SO",
"address_2": "SUITE 103",
"city": "NAMPA",
"state": "ID",
"postal_code": "83651",
"telephone_number": "208-461-3720",
"fax_number": "208-461-1787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 12TH AVE SO",
"address_2": "SUITE 103",
"city": "NAMPA",
"state": "ID",
"postal_code": "83651",
"telephone_number": "208-461-3720",
"fax_number": "208-461-1787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "CORRINE",
"middle_name": "TAFOYA",
"name_prefix": "Mrs.",
"credential": "ACSW LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW562",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "807292400",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "8M061",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "E5428",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nampa, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.